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Comparison of endoscopic versus laparoscopic resection for gastric gastrointestinal stromal tumors: A preliminary meta‐analysis
Author(s) -
Zhu Hanlong,
Zhao Si,
Jiao Ruonan,
Zhou Jian,
Zhang Chunmei,
Miao Lin
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15106
Subject(s) - medicine , meta analysis , stomach , surgery , randomized controlled trial , endoscopy , complication , gastroenterology
Background and Aim For localized disease, complete surgical resection is regarded as the “gold standard” therapeutic modality. With the rapid development of endoscopic techniques, endoscopic resection (ESR) has been confirmed as an efficient and safe alternative for the treatment of gastrointestinal stromal tumors (GISTs) in the stomach. Nevertheless, the management of gastric GISTs remains poorly defined. The purpose of this study is to evaluate the security and effectiveness of ESR with laparoscopic resection (LAR) for gastric GISTs. Methods A literature search of online databases was conducted to identify relevant comparative studies of ESR and LAR procedures for gastric GISTs published before April 10, 2020. The cumulative data analysis was also performed utilizing the software STATA. Results In total, 10 studies involving 1165 patients met the inclusion criteria for analysis (651 for ESR and 514 for LAR). From the results of meta‐analysis, patients who underwent ESR experienced decreased operative time ( P = 0.000), less intraoperative blood loss ( P = 0.002), earlier time to diet ( P = 0.000), shorter hospital stay ( P = 0.000), and lower total charges ( P = 0.000) compared with LAR. Moreover, there were no significant differences between these two approaches concerning tumor rupture, conversion rate to other procedure, complete resection rate, postoperative complication rate, recurrence rate, and disease‐free survival. Conclusions Endoscopic resection, as an effective alternative treatment strategy with satisfactory outcomes, is acceptable for selective patients with gastric GISTs compared with LAR. Further well‐designed randomized controlled trials with large samples are warranted to corroborate our observations.