Zheng Lijun, Ding Weixing, Zhou Donglei, Lu Liesheng, Yao Le
Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University, Shanghai, P.R. China.
Am Surg. 2014 Jan;80(1):48-56.
We conducted our meta-analysis to compare outcomes between laparoscopic resection and open resection for gastric gastrointestinal stromal tumors (GISTs) from all published comparative studies in the literature. Databases, including PubMed, Embase, Cochrane Library, Ovid, Web of Science, and CNKI, were searched to identify studies comparing outcomes after laparoscopic resection and open resection for gastric GISTs. The meta-analysis was performed by RevMan 5.1. Eleven comparative studies comprising 495 patients were identified. Patients undergoing laparoscopic resection of gastric GISTs were found to have similar operative time (weighted mean difference [WMD], 2.29; 95% confidence interval [CI], -16.01 to 11.43; P = 0.74) and complications rate (odds ratio [OR], 0.76; 95% CI, 0.36 to 1.58; P = 0.46). Less intraoperative blood loss (WMD, -55.91; 95% CI, -90.26 to -21.56; P = 0.001), earlier passing first flatus (WMD, -0.89, 95% CI, -1.60 to -0.18; P = 0.01), earlier having the first liquid diet (WMD, -1.54; 95% CI, -2.44 to -0.64; P = 0.0008), and shorter hospital stay (WMD, -4.25; 95% CI, -5.63 to -2.88; P < 0.00001) were observed in the laparoscopic resection group. The recurrence rate was higher in the group of open resection compared with the group of laparoscopic resection (OR, 0.26; 95% CI, 0.09 to 0.75; P = 0.01). Laparoscopic resection is safe and efficient in the treatment of patients with gastric GISTs as compared with open resection procedure. Laparoscopic resection may be a preferred treatment for gastric GISTs.
我们进行了荟萃分析，以比较文献中所有已发表的比较研究中，腹腔镜切除术和开放切除术治疗胃胃肠道间质瘤（GIST）的疗效。检索了包括PubMed、Embase、Cochrane图书馆、Ovid、Web of Science和中国知网在内的数据库，以确定比较腹腔镜切除术和开放切除术治疗胃GIST疗效的研究。使用RevMan 5.1进行荟萃分析。共纳入11项比较研究，涉及495例患者。结果发现，接受腹腔镜切除胃GIST的患者手术时间相似（加权平均差[WMD]，2.29；95%置信区间[CI]，-16.01至11.43；P = 0.74），并发症发生率也相似（比值比[OR]，0.76；95%CI，0.36至1.58；P = 0.46）。腹腔镜切除组术中失血量更少（WMD，-55.91；95%CI，-90.26至-21.56；P = 0.001），首次排气时间更早（WMD，-0.89，95%CI，-1.60至-0.18；P = 0.01），首次进食流食时间更早（WMD，-1.54；95%CI，-2.44至-0.64；P = 0.0008），住院时间更短（WMD，-4.25；95%CI，-5.63至-2.88；P < 0.00001）。与腹腔镜切除组相比，开放切除组的复发率更高（OR，0.26；95%CI，0.09至0.75；P = 0.01）。与开放切除手术相比，腹腔镜切除术治疗胃GIST患者安全有效。腹腔镜切除术可能是胃GIST的首选治疗方法。
