Spread and Development of Laparoscopic Surgery for Gastric Tumors in Mainland China: Initial Experiences

Background/Aims: To introduce the initial experience of the laparoscopic surgery for gastric tumors in mainland China. Methodology: A key Chinese full-text database was comprehensively searched for eligible reports on laparoscopic gastric surgery from 1991 to 2009. Outcomes of laparoscopic gastrectomy for gastric cancer were extracted for pooling estimate. Results: In the period 2003-2008, the amount of relevant journal papers sharply increased (p<0.001). Analysis included 67 reports (no randomized controlled trial, 4 case control studies and the remnant of case series or case reports); 74.6% of the reports were from institutions in the Eastern China region. Finally 542 patients of gastric cancer were analyzed. Early gastric cancer (TNM stage Ia/Ib) was only 30.0%. D2/D2+ lymphadenectomy was performed in 69.0% patients. The combined overall complication and mortality rates were 10.9% and 0.4%, respectively. The incidence of conversion to open surgery and reoperation were 4.1% and 1.1%, respectively. The long-term outcome of 5-year survival rate was unavailable. Conclusions: Laparoscopic gastric surgery has spread rapidly and developed in mainland China during recent several years. The initial experiences from mainland China showed that postoperative complication and mortality rates of laparoscopic gastrectomy for gastric cancer were acceptable and comparable to Japanese and Korean trials.