title: Systematic review and meta-analysis of safety and efficacy of laparoscopic resection for gastrointestinal stromal tumors of the stomach.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of laparoscopic resection for gastrointestinal stromal tumors (GISTs) of the stomach with systematic review and meta-analysis.
  
  
  METHODS
  The literature database before March, 2014 was extensively searched to retrieve the comparative studies of laparoscopic (LAP) and open 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 nineteen studies meeting the inclusion criteria for meta-analysis. The total sample size of these studies was 1,060 cases. The operation time was similar between the two groups [weighted mean difference (WMD) -7.20 min, 95 % confidence interval (CI) -25.65 to 11.25, P = 0.44)]. Compared to OPEN, however, LAP experienced less blood loss (WMD -54.21 ml, 95 % CI -82.65 to -25.77, P < 0.01), earlier time to flatus (WMD -1.34 days, 95 % CI -1.62 to -1.06, P < 0.01) and oral diet (WMD -1.80 days, 95 % CI -2.18 to -1.42, P < 0.01), shorter hospital stay (WMD -3.68 days, 95 % CI -4.52 to -2.85, P < 0.01) and decrease in overall complications [relative risk (RR) 0.51, 95 % CI 0.32-0.80, P < 0.01)]. In addition, the long-term follow-up result shows that there is no significant difference in the two groups of patients.
  
  
  CONCLUSIONS
  Laparoscopic resection for gastric GISTs is a safe and feasible 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 laparoscopic surgery will not increase the risks of tumor relapse and metastasis.
authors.affiliation: Department of General Surgery, Institute of Micro-invasive Surgery, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Chen
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Zhou
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Mou
authors.forename: Xiao-Wu
authors.initials: XW
authors.lastname: Xu
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Jin
authors.forename: Harsha
authors.initials: H
authors.lastname: Ajoodhea
mesh_terms: D005260:Female; D005743:Gastrectomy / Q000379:methods*; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome