Published online Jan 15, 2018. doi: 10.4251/wjgo.v10.i1.48
Peer-review started: October 24, 2017
First decision: November 23, 2017
Revised: December 4, 2017
Accepted: December 6, 2017
Article in press: December 6, 2017
Published online: January 15, 2018
To investigate whether laparoscopic surgery is as safe and feasible as open resection for patients with larger gastrointestinal stromal tumors (GISTs) (≥ 5 cm).
A systematic search of PubMed, EMBASE, Web of Science and the Cochrane Library database was performed. Relevant studies of laparoscopic and open surgery for GISTs of > 5 cm published before December 2016 were identified from these databases. The quality of the studies was assessed by the Newcastle-Ottawa Quality Assessment Scale. The tumor size, operation time, blood loss, postoperative hospital stay, complication rate, and disease-free survival rate were assessed. The software Stata (version 12.0) was used for the meta-analysis.
Five clinical trials comprising 209 patients with GISTs of similar larger sizes were evaluated. The pooled analysis of 100 patients in the laparoscopic resection group and 109 patients in the open resection group demonstrated that laparoscopic surgery was significantly associated with a shorter postoperative hospital stay (P < 0.001) and less blood loss (P = 0.002). Moreover, there were no statistically significant differences in the operation time (P = 0.38), postoperative complication rate (P = 0.88), or disease-free survival rate (P = 0.20) between two groups.
Our findings revealed that for patients with large GISTs of comparable sizes, laparoscopic surgery did not significantly influence the operation factors or clinical outcomes compared with open surgery. This suggests that laparoscopic resection is as acceptable as open surgery for treatment of large gastric GISTs.
Core tip: Whether laparoscopic resection is also effective and feasible for treatment of larger gastric gastrointestinal stromal tumors (GISTs) (> 5 cm) remains unknown. This meta-analysis collected up-to-date clinical data of comparison of laparoscopic and open resection for larger gastric GISTs (> 5 cm). Our results showed that laparoscopic resection is an upgraded minimal invasive technique with a shorter postoperative hospital stay and less intraoperative blood loss compared with open surgery in treating patients with larger GISTs.