Published online Sep 26, 2023. doi: 10.12998/wjcc.v11.i27.6455
Peer-review started: May 20, 2023
First decision: June 15, 2023
Revised: June 29, 2023
Accepted: July 24, 2023
Article in press: July 24, 2023
Published online: September 26, 2023
Processing time: 123 Days and 8.4 Hours
Laparoscopic surgery has been widely used in the treatment of a variety of tumors, but it is still controversial in the treatment of gallbladder cancer. This is the first meta-analysis to compare laparoscopic radical resection (LRR) and open radical resection (ORR) in gallbladder carcinoma (GBC) directly.
This study compared LRR with traditional ORR in the management of GBC. It aimed to resolve the disputes faced by LRR and provide support for further research.
This study aimed to clarify the feasibility of LRR in GBC treatment, and encourage more surgeons to further carry out research on LRR, and move the minimally invasive treatment of gallbladder cancer forward.
We systematically reviewed the literature on the LRR and ORR in GBC, and integrated the available data for meta-analysis. The Begg’s test and Egger’s test were used to assess potential publication bias, and sensitivity analysis was performed to evaluate the stability of the results.
This study found that the LRR group was comparable with the ORR group in long-term and short-term prognosis, and even showed advantages in some aspects, such as tumor-free survival (TFS) in the T2/tumor-node-metastasis (TNM) Ⅱ stage subgroup and postoperative length of stay (POLS). Although there is still a lack of support from randomized controlled trials (RCTs), this result will encourage surgeons to conduct further and more in-depth research.
The meta-analysis results showed that LRR was not inferior to ORR in all measured outcomes and even showed superiority in the TFS of patients with stage T2/TNM Ⅱ disease and POLS. It is the first meta-analysis that excluded interference from simple cholecystectomy cases, and it is also the first time to conduct a subgroup analysis of the data after propensity score matching.
LRR will inevitably play a more important role in the treatment of GBC, considering its minimally invasive characteristics and the advantage of enhanced postoperative recovery. But it requires further research, such as RCT or research on the combination of LRR and adjuvant therapy.