Meta-analysis of laparoscopic and open surgery for gastric gastrointestinal stromal tumor.
OBJECTIVE
A meta-analysis was conducted to evaluate and compare the short- and long-term outcomes of laparoscopic and conventional open surgery for gastric gastrointestinal stromal tumors (GISTs).


METHODS
We searched MEDLINE, EMBASE, Science Citation Index, and the Cochrane Controlled Trial Register for relevant articles published between 2000 and July 2013 by using the search terms "laparoscopic", "laparoscopy-assisted", "surgery", "gastrointestinal tumor", "GIST" and "gastric".


RESULTS
We identified 12 articles reporting results that compared laparoscopic surgery with open surgery for gastric GISTs. Our meta-analysis included 644 patients with GISTs; 312 had undergone laparoscopic surgery, and 332 had undergone open surgery. In the short-term period, 14 outcome variables were examined. In the long-term period, six oncological variables were analyzed. Laparoscopic surgery for gastric GIST was associated with a reduction in intraoperative blood loss, shorter period to flatus, earlier resumption of oral intake, and shorter duration of hospital stay over the short-term, and with a significantly lower rate of overall recurrence, metastatic recurrence and local recurrence in the long-term compared to open surgery.


CONCLUSIONS
Laparoscopic surgery may be an acceptable surgical treatment option compared to open surgery for gastric GIST.
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka, 545-8585, Japan. m5051923@msic.med.osaka-cu.ac.jp.
Hiroshi
H
Ohtani
Kiyoshi
K
Maeda
Eiji
E
Noda
Hisashi
H
Nagahara
Masatune
M
Shibutani
Masaichi
M
Ohira
Kazuya
K
Muguruma
Hiroaki
H
Tanaka
Naoshi
N
Kubo
Takahiro
T
Toyokawa
Katsunori
K
Sakurai
Yoshito
Y
Yamashita
Atsushi
A
Yamamoto
Kosei
K
Hirakawa
D005743:Gastrectomy; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D011183:Postoperative Complications; D011379:Prognosis; D013274:Stomach Neoplasms / Q000601:surgery*
GIST; Gastric gastrointestinal stromal tumor; gastric; laparoscopy-assisted surgery; meta-analysis