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- Title
Systematic review and meta-analysis of safety and efficacy of laparoscopic resection for gastrointestinal stromal tumors of the stomach.
- Authors
Chen, Ke; Zhou, Yu-Cheng; Mou, Yi-Ping; Xu, Xiao-Wu; Jin, Wei-Wei; Ajoodhea, Harsha
- Abstract
Objective: To evaluate the safety and efficacy of laparoscopic resection for gastrointestinal stromal tumors (GISTs) of the stomach with systematic review and meta-analysis. Methods: The literature database before March, 2014 was extensively searched to retrieve the comparative studies of laparoscopic (LAP) and open resection (OPEN) for GISTs with a relevance of study goal. The inclusion and exclusion criteria were formulated. After a quality evaluation, the data were extracted. The Cochrane collaboration RevMan5.1 version software was used for meta-analysis. Results: There are nineteen studies meeting the inclusion criteria for meta-analysis. The total sample size of these studies was 1,060 cases. The operation time was similar between the two groups [weighted mean difference (WMD) −7.20 min, 95 % confidence interval (CI) −25.65 to 11.25, P = 0.44)]. Compared to OPEN, however, LAP experienced less blood loss (WMD −54.21 ml, 95 % CI −82.65 to −25.77, P < 0.01), earlier time to flatus (WMD −1.34 days, 95 % CI −1.62 to −1.06, P < 0.01) and oral diet (WMD −1.80 days, 95 % CI −2.18 to −1.42, P < 0.01), shorter hospital stay (WMD −3.68 days, 95 % CI −4.52 to −2.85, P < 0.01) and decrease in overall complications [relative risk (RR) 0.51, 95 % CI 0.32-0.80, P < 0.01)]. In addition, the long-term follow-up result shows that there is no significant difference in the two groups of patients. Conclusion: Laparoscopic resection for gastric GISTs is a safe and feasible procedure with less blood loss, less overall complications and quicker recovery. The long-term survival situation of patients mainly depends on the tumor itself risk, and laparoscopic surgery will not increase the risks of tumor relapse and metastasis.
- Subjects
GASTROINTESTINAL stromal tumors; GASTRECTOMY; LAPAROSCOPY; LAPAROSCOPIC surgery complications; META-analysis; SYSTEMATIC reviews
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2015, Vol 29, Issue 2, p355
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-014-3676-6