Totally laparoscopic gastrectomy for gastric cancer: A systematic review and meta-analysis of outcomes compared with open surgery

Table 4 Subgroup analysis of learning curve using a cut-point of 40 totally laparoscopic gastrectomy cases

Outcomes	No. of studies	Sample size		Heterogeneity	Overall effect size	95%CI of overall effect	P value
		TLG	OG	(P value, I2)
Operation time (min)
< 40 TLG cases	9	256	262	< 0.001, 92%	WMD = 60.54	35.64-85.45	< 0.001
> 40 TLG cases	5	465	549	< 0.001, 99%	WMD = 53.91	16.74-91.08	0.004
Blood loss (mL)
< 40 TLG cases	8	226	232	< 0.001, 84%	WMD = -155.04	-133.22	< 0.001
> 40 TLG cases	4	326	342	< 0.001, 85%	WMD = -194.81	-95.98	< 0.001
Retrieved lymph nodes
< 40 TLG cases	8	218	240	0.23, 25%	WMD = -1.41	-6.11	0.37
> 40 TLG cases	5	465	549	0.06, 63%	WMD = 0.03	-4.27	0.98

TLG: Totally laparoscopic gastrectomy; OG: Open gastrectomy; WMD: Weighted mean difference.