Meta-analysis of Safety and Efficacy of Laparoscopic Resection for Gasric Stromal Tumors

Yuchen Zhou, MS, Ke Chen, MS, Yiping Mou, MD, FACS. Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University.

INTRODUCTION: To evaluate the safety and efficacy of laparoscopic resection for gastric stromal tumors with systematic review and meta-analysis.

METHODS AND PROCEDURES: The literature database before September, 2013 was extensively searched to retrieve the comparative studies of laparoscopic (LR) and open resection(OR) for gastric stromal tumors 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 thirteen studies meeting the inclusion criteria for meta-analysis. The total sample size of these studies was 792 cases. The operation time was similar between the two groups [weighted mean difference (WMD)= -7.57min, 95% confidence interval(CI): -32.86 ~ 17.73, P=0.56)]. Compared to OR, however, LR experience less blood loss (WMD = -48.88 ml, 95% CI: -72.90 ~ -24.85, P<0.001), earlier time to ?atus (WMD = -1.60 d, 95% CI: -2.03 ~ -1.17, P<0.001) and oral diet (WMD = -1.68 d, 95% CI: -2.33 ~ -1.03, P<0.001), shorter hospital stay (WMD = -3.55 d, 95% CI: -4.56 ~ -2.53, P<0.001) and decrease in overall complications [relative risk(RR)= 0.57, 95% CI: 0.33 ~ 0.97, P=0.04)]. In addition, the long-term follow-up result shows that there is no significant difference in the two groups of patients.

CONCLUSIONS: laparoscopic resection for gastrointestinal stromal tumors of the stomach is a safe and feasible procedure with less blood loss, less overall complications and quick recovery. The long-term survival situation of gastric stromal tumor patients mainly depends on the tumor itself risk, and laparoscopic surgery will not increase the risk of tumor relapse and metastasis.

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