AIM:To evaluate the safety and efficacy of laparoscopy-assisted total gastrectomy(LATG)and open total gastrectomy(OTG)for gastric cancer.METHODS:A comprehensive search of PubMed,Cochrane Library,Web of Science and BIOSIS Previews was performed to identify studies that compared LATG and OTG.The following factors were checked:operating time,blood loss,harvested lymph nodes,flatus time,hospital stay,mortality and morbidity.Data synthesis and statistical analysis were carried out using RevMan 5.1 software.RESULTS:Nine studies with 1221 participants were included(436 LATG and 785 OTG).Compared to OTG,LATG involved a longer operating time[weighted mean difference(WMD)=57.68 min,95%CI:30.48-84.88;P<0.001];less blood loss[standard mean difference(SMD)=-1.71;95%CI:-2.48--0.49;P<0.001];earlier time to flatus(WMD=-0.76 d;95%CI:-1.22--0.30;P<0.001);shorter hospital stay(WMD=-2.67d;95%CI:-3.96--1.38,P<0.001);and a decrease in medical complications(RR=0.41,95%CI:0.19-0.90,P=0.03).The number of harvested lymph nodes,mortality,surgical complications,cancer recurrence rate and long-term survival rate of patients undergoing LATG were similar to those in patients undergoing OTG.CONCLUSION:Despite a longer operation,LATG can be performed safely in experienced surgical centers with a shorter hospital stay and fewer complications than open surgery. AIM: To evaluate the safety and efficacy of laparoscopy-assisted total gastrectomy (LATG) and open total gastrectomy (OTG) for gastric cancer. METHODS: A comprehensive search of PubMed, Cochrane Library, Web of Science and BIOSIS Previews was performed to identify studies that compared LATG and OTG.The following factors were checked: operating time, blood loss, harvested lymph nodes, flatus time, hospital stay, mortality and morbidity. Data synthesis and statistical analysis were carried using using RevMan 5.1 software.RESULTS: Nine studies with 1221 participants were included (436 LATG and 785 OTG) .Compared to OTG, LATG involved a longer operating time [weighted mean difference (WMD) = 57.68 min, 95% CI: 30.48-84.88; P <0.001] 95% CI: -2.48--0.49; P <0.001]; earlier time to flatus (WMD = -0.76 d; 95% CI: -1.22--0.30; P <0.001) ; shorter hospital stay (WMD = -2.67d; 95% CI: -3.96-1.38, P <0.001); and a decrease in medical complications (RR = 0.41, 95% CI: 0.19-0.90, P = 0.03). The number of harve sted lymph nodes, mortality, surgical complications, cancer recurrence rate and long-term survival rate of patients undergoing LATG were similar to those in patients undergoing OTG.CONCLUSION: Despite a longer operation, LATG can performed safely in experienced surgical centers with shorter hospital stay and fewer complications than open surgery.