Comparison of efficacy and safety between endoscopic and laparoscopic resections in the treatment of gastric stromal tumors: a systematic review and meta-analysis

[摘要] Background: There are still clinical controversy on the efficacy and safety of endoscopic resection (ER) and laparoscopic resection (LR) in the treatment of gastrointestinal stromal tumors (GISTs). The present study aimed to evaluate the safety and efficacy of ER in the treatment of GISTs by comparing the relative outcomes of ER to LR. Methods: PubMed, Web of Science, Cochrane Library, and Embase were searched. Data were retrieved from January 2010 to January 2020 and subjected to a meta-analysis based on the intraoperative and postoperative outcomes of ER and LR. The intervention arm was treated by LR while the comparator arm was treated by ER. Relevant literature was selected based on the inclusion criteria, data was extracted, and quality evaluation of the included literature was carried out. The Newcastle-Ottawa Scale (NOS) was applied for assessing the quality of included studies. Heterogeneity between studies was assessed using the Cochrane χ2 test and I2 statistic, and Funnel plots and Egger’s test were used to detect publication bias. Results: The present analysis included 13 studies, comprising a total of 1,261 patients, (ER vs. LR: 543 vs.0.10), and the sensitivity analysis showed that the study was robust. Conclusions: ER was safer and more efficient than LR in terms of all the outcomes, except the R0 resection rate. Thus, ER should be considered the treatment of choice. However, attention should be paid to the surgical margin status following ER.

[学科分类] 肿瘤学

[关键词] Gastrointestinal stromal tumor (GIST);endoscope;laparoscopic;meta-analysis