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A Systematic Review and Meta-Analysis of Open vs. Laparoscopic Resection of Gastric Gastrointestinal Stromal Tumors.

Pelletier JS, Gill RS, Gazala S, Karmali S - J Clin Med Res (2015)

Bottom Line: The laparoscopic approach was associated with a significantly lower length of hospital stay (3.82 days (2.14 - 5.49)).There was no observed difference in operative time, adverse events, estimated blood loss, overall survival and recurrence rates.This study supports that laparoscopic resection is safe and effective for gastric GISTs and is associated with a significantly lower length of hospital stay.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.

ABSTRACT
Gastric gastrointestinal stromal tumors (GISTs) are the most common sarcoma of the gastrointestinal tract, and surgical resection is the primary treatment of early disease. Limited data exist concerning laparoscopic resections of these neoplasms. This systematic review was designed to evaluate the literature comparing laparoscopic and open surgical resection of gastric GISTs and to assess the effectiveness and safety of this minimally invasive technique. We performed a systematic search of MEDLINE, the Cochrane Library, PubMed, Embase, Scopus, Web of Science, Google Scholar, the clinical trials database and ProQuest Dissertations and Theses as well as the past 3 years of conference abstracts from the Society of American Gastrointestinal and Endoscopic Surgeons Annual Meetings. Studies comparing the open and the laparoscopic approaches to the resection of gastric GISTs were included in this systematic review. Two reviewers independently performed the screen of titles and abstracts, the full manuscript review, the data extraction and the risk of bias assessment. A quantitative analysis was performed. Of the 189 studies identified, seven studies were included. The laparoscopic approach was associated with a significantly lower length of hospital stay (3.82 days (2.14 - 5.49)). There was no observed difference in operative time, adverse events, estimated blood loss, overall survival and recurrence rates. This study supports that laparoscopic resection is safe and effective for gastric GISTs and is associated with a significantly lower length of hospital stay. Further trials are needed for cost analysis and to rigorously assess oncologic outcomes.

No MeSH data available.


Related in: MedlinePlus

Forest plot depicting the mean differences in the estimated blood loss (mL) in the included studies, if reported.
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Figure 5: Forest plot depicting the mean differences in the estimated blood loss (mL) in the included studies, if reported.

Mentions: As for our secondary outcomes, four studies [1, 3, 13, 14] reported on their conversion rate from laparoscopic to open, with five conversions out of 97 operations for a conversion rate of 5.2%. A pain assessment was only performed in one of the included studies [14], and they did find that patients undergoing laparoscopic surgery had significantly less pain in the first 3 days post-operatively. Pain was then found to be the equivalent in both groups on the forth post-operative day. Four studies reported on estimated blood loss, and no difference was found between the open and the laparoscopic group (Fig. 5).


A Systematic Review and Meta-Analysis of Open vs. Laparoscopic Resection of Gastric Gastrointestinal Stromal Tumors.

Pelletier JS, Gill RS, Gazala S, Karmali S - J Clin Med Res (2015)

Forest plot depicting the mean differences in the estimated blood loss (mL) in the included studies, if reported.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356087&req=5

Figure 5: Forest plot depicting the mean differences in the estimated blood loss (mL) in the included studies, if reported.
Mentions: As for our secondary outcomes, four studies [1, 3, 13, 14] reported on their conversion rate from laparoscopic to open, with five conversions out of 97 operations for a conversion rate of 5.2%. A pain assessment was only performed in one of the included studies [14], and they did find that patients undergoing laparoscopic surgery had significantly less pain in the first 3 days post-operatively. Pain was then found to be the equivalent in both groups on the forth post-operative day. Four studies reported on estimated blood loss, and no difference was found between the open and the laparoscopic group (Fig. 5).

Bottom Line: The laparoscopic approach was associated with a significantly lower length of hospital stay (3.82 days (2.14 - 5.49)).There was no observed difference in operative time, adverse events, estimated blood loss, overall survival and recurrence rates.This study supports that laparoscopic resection is safe and effective for gastric GISTs and is associated with a significantly lower length of hospital stay.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.

ABSTRACT
Gastric gastrointestinal stromal tumors (GISTs) are the most common sarcoma of the gastrointestinal tract, and surgical resection is the primary treatment of early disease. Limited data exist concerning laparoscopic resections of these neoplasms. This systematic review was designed to evaluate the literature comparing laparoscopic and open surgical resection of gastric GISTs and to assess the effectiveness and safety of this minimally invasive technique. We performed a systematic search of MEDLINE, the Cochrane Library, PubMed, Embase, Scopus, Web of Science, Google Scholar, the clinical trials database and ProQuest Dissertations and Theses as well as the past 3 years of conference abstracts from the Society of American Gastrointestinal and Endoscopic Surgeons Annual Meetings. Studies comparing the open and the laparoscopic approaches to the resection of gastric GISTs were included in this systematic review. Two reviewers independently performed the screen of titles and abstracts, the full manuscript review, the data extraction and the risk of bias assessment. A quantitative analysis was performed. Of the 189 studies identified, seven studies were included. The laparoscopic approach was associated with a significantly lower length of hospital stay (3.82 days (2.14 - 5.49)). There was no observed difference in operative time, adverse events, estimated blood loss, overall survival and recurrence rates. This study supports that laparoscopic resection is safe and effective for gastric GISTs and is associated with a significantly lower length of hospital stay. Further trials are needed for cost analysis and to rigorously assess oncologic outcomes.

No MeSH data available.


Related in: MedlinePlus