Laparoscopic Versus Open Wedge Resection For Gastrointestinal Stromal Tumors Of Stomach:A Meta-analysis

Objective:To evaluate the feasibility and safety of laparoscopic wedge resection for gastrointestinal stromal tumors (GISTs) of the stomach with systematic review and meta-analysis.Methods:The literature database before November,2014 was extensively searched to retrieve the comparative studies of laparoscopic (LAP) and open wedge 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 ten studies meeting the inclusion criteria for meta-analysis. The total sample size of these studies was 485 cases. The operation time was similar between the two groups [weighted mean difference (WMD) 8.67 min,95% conâ–¡dence interval (CI)-8.60 to 25.94, P= 0.33)]. Compared to OPEN, however, LAP experienced less blood loss (WMD-32.20 ml, 95%CI-56.15 to-8.26, P<0.01), earlier time to â–¡atus (WMD-1.48 days, 95%CI-1.90 to-1.06, P<0.01) and oral diet (WMD-1.50 days,95%CI-2.25 to -0.47, P<0.01), shorter hospital stay (WMD-2.03 days,95%CI-2.68 to -1.38, P<0.01) and decrease in overall complications [relative risk (RR) 0.48,95% CI 0.25-0.89, P=0.01)]. In addition, the long-term follow-up result shows that there is no signiâ–¡cant difference in the two groups of patients.Conclusion:LAP wedge resection for gastric GISTs is a feasible and safe 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 LAP surgery will not increase the risks of tumor recurrence and metastasis.