Table 2. Summary information of included studies.
Studies | Demographic data | Intervention | JS/NOS |
Inoue K, et al [37],2012, Japan, RCT | 30 patients in each group with resectable GCwere underwent open gastrectomy with D0–D2dissection. Combined resections includinggallbladder, spleen and spleen pancreatic tailwere performed in 6 patients in each group. | USS group: harmonic focus USS for ≤5 mmvessels and lymphatics and electrocautery for dissectionof avascular planes, minute vessels and lymphatics.Conventional group: only electrocautery and ligation with silk thread. | 1 |
Tsimoyiannis EC,et al [20], 2001,Greece, RCT | 20 patients in each group were underwent opentotal or subtotal gastrectomy with D2dissection. Spleen was resected in carcinomaof cardia, fundus and upper part of the corpus. | USS group: ultracision harmonic shears of 10 mmin all steps of dissection, hemoclips or ligations forblood vessels more than 3 mm. Conventional group: monopolar electrosurgeryfor cutting and coagulation, hemoclips or ligations to obstruct the vessels. | 1 |
Chen CP [25],2012, China,RCT | 60 patients in each group were underwentgastrectomy with D2 dissection. | USS group: GEN300/STM (5 mm) USS.Conventional group: unclear. | 2 |
Liu L, et al [26],2010, China,RCT | 19 patients in USS group and 21 inconventional group were underwent distalgastrectomy with D2 dissection. | USS group: GEN300/STM (5 mm) USS.Conventional group: monopolar electrocautery was used inall the course of operations. | 2 |
Xu L, et al [34],2010, China,RCT | 23 patients in USS group and 19 inconventional group underwent gastrectomywith D2 dissection. | USS group: Ethicon USS.Conventional group: monopolar electrocautery and ligation. | 1 |
Zhang ZY [27],2012, China,RCT | 50 patients in USS group and 48 inconventional group were underwent radicalgastrectomy. | USS group: SONACA150 USS for ≤5 mm vessels andGN300 electrocautery. Conventional group: GN 300electrocautery and ligation. | 3 |
Lu WQ, et al [30],2008, China,RCT | 26 patients in USS group and 23 inconventional group were underwentgastrectomy with D2 dissection. | USS group: GEN 300 STM 5 mm.Conventional group: GD 350-Dmonopolar electrocautery. | 1 |
Mohri Y, et al[21], 2007, Japan,nRCT | 26 patients in each group with ≥7 cmGC were underwent primary open totalor distal gastrectomy with D1–D2dissection. 26 patients wereunderwent adjacent organ resection. | USS group: ultracision harmonic shears used in all stepsof dissection to seal lymphatic tissue and ligate theperigastric vessels. Left and right gastroepiploic andgastric vessels were ligated. Conventional group: onlymonopolar electrosurgery for cutting and coagulation.The blood vessels and main lymphatic vessels were ligated. | 8 |
Li G, et al [19],2010, China,nRCT | 97 in USS and 122 in conventionalgroup were underwent gastrectomy withD2 dissection. | USS group: GEN 300/STM (5 mm) USS.Conventional group: GD-350D monopolar electrocautery. | 9 |
Wei ZM, et al[22], 2010,China, nRCT | 34 patients in USS group and 38 inconventional group, who were morethan 60 years were underwentgastrectomy with D2 dissection. | USS group: ultrasonic harmonic scalpel for ≤5 mmvessels and ligation for >5 mm vessels. Conventionalgroup: monopolar electrocautery and other conventionaltechniques for division, ligation and cutting. | 7 |
Tu JC, et al [23],2010, China,nRCT | 156 patients in USS group and 140 inconventional group were underwentstandard distal gastrectomy withD2+No.14V dissection. | USS group: GEN300 USS was used for vessels exceptleft and right gastric, right gastroepiploic vessels.Conventional group: monopolar electrocautery and ligation | 8 |
Fu YM [24],2011, China,nRCT | 70 patients in each group wereunderwent gastrectomy with D2dissection. | USS group: USS resources unclear. Dissected allLN then cut off stomach and duodenum. Conventionalgroup: dissected NO.6 and NO12a LN then cut offstomach and duodenum, then dissected other LN. | 8 |
Li P, et al [28],2011, China,nRCT | 111 patients in USS group and 120 inconventional group underwentgastrectomy with D2 dissection. | USS group: GEN 300/STM (5 mm) USS.Conventional group: GD-350D monopolarelectrocautery and ligation in all course operation. | 9 |
Tu XH, et al [29],2009, China,nRCT | 42 patients in USS group and 54 inconventional group were underwenttotal and distal gastrectomy with D2dissection. | USS group: harmonic wave TM and harmonicTM 300 (CEN 04). Conventional group: monopolar electrocautery. | 9 |
Chen Z, et al [31],2009, China,nRCT | 21 patients in USS group and 25 inconventional group were underwentradical gastrectomy. | USS group: USS from Harmonic Ethicon Endo.Conventional group: Force FXTM-8C. | 7 |
Li ZR, et al [32],2009, China,nRCT | 49 patients in USS group and 56 inconventional group were underwentgastrectomy with D2+NO14v LNdissection. | USS group: GEN 300/STM (5 mm).Conventional group: GD-3502D monopolar electrocautery | 9 |
Lin YH, et al[33], 2011,China, nRCT | 35 patients in USS group and 28patients in conventional groupwere underwent gastrectomy withD2+NO.14v LN dissection. | USS group: GEN 300 USS and monopolar electrocautery.Conventional group: monopolar electrocautery and ligation. | 9 |
Shi YF, et al [35],2012, China,nRCT | 30 patients in USS and 30 inconventional group wereunderwent gastrectomywith D2 dissection. | USS group: GEN300 USS alone for all vessels but withligation for left and right gastroepiploic and gastric vessels.Conventional group: GD-350D monopolar electrocautery and ligation. | 9 |
Song XP, et al[36], 2011,China, nRCT | 47 patients in USS group and 54 inconventional group wereunderwent gastrectomy with D2dissection. | USS group: OLYMPUS USSfor ≤3 mm vessels without ligation.Conventional group: monopolar electrocautery. | 8 |
Abbreviations: GC: gastric carcinoma; USS: ultrasonic scalpel; RCT: randomized controlled trials; nRCT: non-randomized controlled trials; LN: lymph nodes; JS: Jadad Scale; NOS: Newcastle-Ottawa Scale; JS was for RCTs and NOS for nRCTs.