胃肠道间质瘤的开放性和微创手术：系统评价和网络荟萃分析方案。
Open and minimally invasive surgery for gastrointestinal stromal tumours: a systematic review and network meta-analysis protocol.
机构信息
Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China.
Department of Pharmacy, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
出版信息
BMJ Open. 2022 Feb 7;12(2):e050414. doi: 10.1136/bmjopen-2021-050414.
INTRODUCTION
Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the digestive system, and complete resection is the only way to provide a radical cure for resectable GISTs. Open surgery and minimally invasive approaches, including laparoscopy, robotic surgery and endoscopy, consist of the mainstream GIST resection. However, there is still a lack of evidence regarding which surgical outcomes and long-term prognosis would be better. Thus, we are planning to conduct a network meta-analysis and systematic review aiming to determine the comparative effectiveness among laparotomy, laparoscopy, endoscopy, robotic surgery, and laparoscopic and endoscopic cooperative surgery in GISTs.
METHOD AND ANALYSIS
PubMed, EMBASE, the Cochrane Library and Web of Science will be searched for published studies to identify the proper literature comparing open resection, laparoscopy, endoscopy, robotic surgery, and laparoscopic and endoscopic cooperative surgery for resecting GISTs from inception to February 2021. Randomised controlled trials (RCTs) and non-randomised studies comparing at least two different interventions for GIST resection will be included. RCTs and non-randomised studies will be synthesised and analysed separately. Bayesian network meta-analysis will be performed to compare the surgical outcomes and long-term prognosis among the resection methods above. The included studies will be divided into several subgroups according to tumour location and size for further analysis. Sensitivity analysis will be performed to identify and explain heterogeneity to make our results robust. Meta-regression will serve as a supplementary method if data are available. The quality of evidence will be evaluated by the Grading of Recommendations, Assessment, Development and Evaluation.
ETHICS AND DISSEMINATION
No ethical approval is required for this network meta-analysis, as it is based on already published data. The findings of the review will be published in a peer-reviewed journal.
PROSPERO REGISTRATION NUMBER
CRD42021237892.
简介
胃肠道间质瘤（GISTs）是消化系统最常见的间叶源性肿瘤，完整切除是可切除 GIST 根治性治疗的唯一方法。开放性手术和微创方法，包括腹腔镜、机器人手术和内镜，构成了 GIST 切除的主流。然而，哪种手术效果和长期预后更好仍缺乏证据。因此，我们计划进行一项网络荟萃分析和系统评价，旨在确定剖腹手术、腹腔镜、内镜、机器人手术和腹腔镜与内镜联合手术治疗 GIST 的比较效果。
方法与分析
从建库至 2021 年 2 月，我们将检索 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 以确定比较开放切除、腹腔镜、内镜、机器人手术和腹腔镜与内镜联合手术治疗 GIST 的适当文献。将纳入比较 GIST 切除术至少两种不同干预措施的随机对照试验（RCTs）和非随机研究。将分别对 RCTs 和非随机研究进行综合和分析。将进行贝叶斯网络荟萃分析，以比较上述切除方法的手术效果和长期预后。根据肿瘤位置和大小，将纳入的研究分为几个亚组进行进一步分析。如果数据可用，将进行敏感性分析以确定和解释异质性，使我们的结果更稳健。如果数据可用，将进行 meta 回归作为补充方法。将使用推荐、评估、制定和评估（GRADE）对证据质量进行评估。
伦理与传播
由于这是一项基于已发表数据的网络荟萃分析，因此不需要伦理批准。审查的结果将发表在同行评议的期刊上。
PROSPERO 注册号：CRD42021237892。
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