Gastrectomy and D2 Lymphadenectomy for Gastric Cancer: A Meta-Analysis Comparing the Harmonic Scalpel to Conventional Techniques
Table 4
Summary of primary and sensitivity analyses.
Operating time (min) (MD [95% CI])
Intraoperative blood loss (mL) (MD [95% CI])
Drainage volume (mL) (MD [95% CI])
LOS (days) (MD [95% CI])
Complications () (RR [95% CI])
Patient transfusions () (RR [95% CI])
Primary analysis
−27.50 (−42.20, −12.81)
−93.15 (−125.29, −61.00)
−138.83 (−177.57, −100.10)
−0.63 (−2.48, 1.23)
0.58 (0.33, 1.02)
0.68 (0.38, 1.19)
Sensitivity analyses
Excluding “lower” quality studies (Tsimoyiannis et al., 2002 [28], Chen, 2012 [20], and Inoue et al., 2012 [26])
−28.66 (−49.47, −7.85)
−79.20 (−118.09, −40.32)
−126.00 (−161.92, −90.08)
Too few studies (<2) to inform
0.41 (0.18, 0.92)
Too few studies (<2) to inform
Only monopolar electrosurgery (i.e., excluding suture ligation)
−45.15 (−58.96, −31.33)
−91.59 (−137.55, −45.62)
−93.55 (−114.08, −73.02)
Too few studies (<2) to inform
Too few studies (<2) to inform
Too few studies (<2) to inform
Excluding imputed data (Inoue et al., 2012 [26], Wilhelm, 2011 [23], and Lu et al., 2008 [24])
−27.62 (−43.84, −11.41)
−91.92 (−124.39, −59.45)
−157.39 (−196.50, −118.27)
−1.07 (−4.53, 2.40)
0.58 (0.33, 1.02)
0.68 (0.38, 1.19)
CI: confidence interval; LOS: length of stay; MD: mean difference; RR: relative risk. Lower quality study defined as ≥4 “unclear” or one “No” listed in any risk of bias assessment category.
