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Systematic review and meta-analysis of safety and efficacy of laparoscopic resection for gastrointestinal stromal tumors of the stomach

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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.

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Acknowledgments

This study was supported by Zhejiang Key Subject of Medical Science Foundation (grant No.11-CX-21).

Disclosures

Ke Chen, Yu-Cheng Zhou, Yi-Ping Mou, Xiao-Wu Xu, Wei-Wei Jin and Harsha Ajoodhea have no conflict of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of General Surgery, Institute of Micro-invasive Surgery, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, China

    Ke Chen, Yu-Cheng Zhou, Yi-Ping Mou, Xiao-Wu Xu, Wei-Wei Jin & Harsha Ajoodhea

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  1. Ke Chen
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Correspondence to Yi-Ping Mou.

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Chen, K., Zhou, YC., Mou, YP. et al. Systematic review and meta-analysis of safety and efficacy of laparoscopic resection for gastrointestinal stromal tumors of the stomach. Surg Endosc 29, 355–367 (2015). https://doi.org/10.1007/s00464-014-3676-6

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  • DOI: https://doi.org/10.1007/s00464-014-3676-6

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