Feasibility of laparoscopic surgery for large gastric gastrointestinal stromal tumors: systematic review and meta-analysis
Ayman Muheisen Salem Alhouli, Assaf Khalid Alsirhani, Abdullah Khalid Abdullah Alghutayghit, Faisal Khalid Saad Alrashed, Abdullah Alturqi Kurdi Alanazi, Ayman Muheisen Salem Alhouli, Abdulaziz Saleh Daham Aldaham.
Abstract
Background: Surgical resection of gastric gastrointestinal stromal tumors (GISTs) via laparoscopy is the gold standard of treatment, but an open laparotomy is the preferred mode of treatment if the patient is unstable. This study aims at comparing the feasibility and safety of laparoscopic versus open resection for gastric GISTs larger than 5 cm.
Methods: A systematic search was performed over different medical databases to identify general surgery studies, which studied the outcome of the laparoscopic group versus the open surgery group of large GIST patients. Furthermore, a meta-analysis was performed on blood loss and length of hospital stay (LOS) as primary efficacy outcomes and overall complications and recurrence rates as secondary safety outcomes.
Results: Nine studies were identified involving 564 patients, 274 patients in the laparoscopic group, and 290 patients in the open surgery group. Our meta-analysis analysis showed a highly significant decrease in mean blood loss, LOS and complications rate in the laparoscopic group compared to the open surgery group (p 0.05).
Conclusion: To conclude, the laparoscopic approach was associated with decreased length of stay, a trend to less blood loss, and common complications compared with the open surgical approach, but there was no significant difference between both groups according to tumor recurrence.
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