Introduction
The operation
Short-term surgical outcomes
Operative time and learning curve
Blood loss
Pancreatic fistula
Conversion to open and peri-operative mortality or anastomotic leak
Oncological outcomes
Cancer stage
Lymph node yield
Study | Number of RAG (Total in study) | Type of RAG resection | % early tumours (< T2N1) | Country | BMI (mean kg/m2) | Outcome summary |
---|---|---|---|---|---|---|
Song et al. (2009) [25] | 40 RAG 20 LAG 20 | Subtotal | 100 | South Korea | 23 | Increased operative time RAG |
Kim et al. (2010) [82] | 39 RAG 12 LAG 11 OG 16 | Subtotal | 100 | South Korea | 21 | Increased operative time RAG Reduced blood loss and LOS RAG |
Woo et al. (2011) [62] | 827 RAG 236 LAG 591 | Subtotal (73%) Total (27%) | 93 | South Korea | 23 | Increased operative time RAG Reduced blood loss RAG |
Kim et al. (2012) [83] | 5839 RAG 436 LAG 861 OG 4542 | Subtotal (75%) Total (25%) | 86 | South Korea | 24 | Increased operative time RAG Makes comparisons between MIG and OG; increased anastomotic leak in MIG, reduced post op ileus and LOS in MIG |
Park et al. (2012) [32] | 150 RAG 30 LAG 120 | Subtotal | 100 | South Korea | 24 | Increased operative time RAG Reduced performance status and drain output in RAG |
Eom et al. (2012) [84] | 92 RAG 30 LAG 62 | Subtotal | 92 | South Korea | 24 | Increased operative time RAG, smaller proximal margin RAG and increased cost |
Huang et al. (2012) [85] | 689 RAG 39 LAG 64 OG 586 | Subtotal (96%) Total (4%) | 93 | Taiwan | 24 | Reduced blood loss and LOS RAG Increased operative time RAG |
Uyama et al. (2012) [86] | 250 RAG 25 LAG 225 | Subtotal | 100 | Japan | 22 | Decreased LOS RAG |
Kang et al. (2012) [87] | 382 RAG 100 LAG 282 | Subtotal (84%) Total (16%) | 93 | South Korea | 24 | Increased LOS for RAG Reduced blood loss RAG |
Yoon et al. (2012) [88] | 101 RAG 36 LAG 65 | Total | 100 | South Korea | 23 | Increased operative time RAG |
Hyun et al. (2013) [54] | 121 RAG 38 LAG 83 | Subtotal (76%) Total (24%) | 87 | South Korea | 24 | RAG group statistically younger Subgroup analysis of “obese” pts (BMI > 25) showed reduced lymph node yield in RAG |
Son et al.(2014) [52] | 109 RAG 51 LAG 58 | Total | 74 | South Korea | 23 | Increased operative time RAG Increased lymph node yield along splenic artery RAG |
Noshiro et al. (2014) [43] | 181 RAG 21 LAG 160 | Subtotal | 85 | Japan | 23 | Reduced LOS RAG |
Huang et al. (2014) [85] | 145 RAG 72 LAG 73 | Subtotal (94%) Total (6%) | 90 | China | 24 | Increased cost and operative time RAG Decreased blood loss RAG |
Junfeng et al. (2014) [89] | 514 RAG 120 LAG 394 | Subtotal (78%) Total (22%) | 45 | China | 22 | Increased operative time, lymph node yield RAG Reduced blood loss RAG |
Park et al. (2015) [90] | 770 RAG 148 LAG 622 | Mixed Subtotal (75%) Total (25%) | 97 | South Korea | 24 | Increased operative time RAG |
Lee et al. (2015) [53] | 400 RAG 133 LAG 267 | Subtotal | 82 | South Korea | 23 | Increased operative time, decreased blood loss RAG Increased lymph node yield in “obese” (BMI 27) patients in RAG (RAG group was statistically younger) |
Kim et al. (2016) [91] | 370 RAG 185 LAG 185 | Subtotal | 94 | South Korea (multicentre) | 24 | Increased operative time RAG |
Okumura et al. (2016) [92] | 502 RAG 370 LAG 132 | Subtotal (77%) Total (23%) | 85 | Japan | 24 | Increased operative time RAG RAG is safe in the elderly (mean age 70) |
Parisi et al. (2017) [18] | 604 RAG 151 LAG 151 OG 302 | Mixed Subtotal (74%) Total (26%) | 75 | Multicentre (IMIGASTRIC) | 24 | Increased operative time RAG Reduced LOS RAG/LAG |
Yang et al. (2017) [93] | 915 RAG 173 LAG 511 OG 241 | Mixed Subtotal (86%) Total (14%) | 88 | South Korea | 24 | Decreased LOS MIG |
Li et al. (2018) [19] | 224 RAG 112 LAG 112 | Mixed Subtotal (57%) Total (43%) | 35 | China | 24 | Increased operative time RAG Reduced blood loss RAG Increased cost RAG |
Liu et al. (2018) [94] | 235 RAG 100 LAG 135 | Mixed Subtotal (58%) Total (42%) | 40 | China | 21 | Reduced LOS RAG |
Gao et al. (2019) [95] | 326 RAG 163 LAG 163 | Mixed Subtotal (62%) Total (38%) | 35 | China | 24 | Increased operative time and cost for RAG |
Pugliese et al. (2009) [68] | 64 RAG 16 LAG 48 | Subtotal | 55 | Italy | 29 | No difference |
Caruso et al. (2011) [55] | 169 RAG 29 OG 120 | Subtotal (59%) Total (41%) | 76 | Italy | 28 | Increased operative time RAG Reduced blood loss and LOS RAG Reduced lymph node yield RAG |
Cianchi et al. (2016) [51] | 71 RAG 41 LAG 30 | Distal | 73 | Italy | 27 | Increased operative time RAG Increased number of lymph nodes retrieved in RAG |
Procopiuc et al. (2016) [23] | 47 RAG 18 OG 29 | Mixed Subtotal (44%) Total (56%) | 50 | Romanian | 26 | Increased operative time RAG |
Caruso et al. (2018) [47] | 39 RAG 19 LAG 20 | Total | Unknown | Spain | Unknown | Increased operative time RAG Reduced blood loss and LOS RAG |