Safety And Efficiency Of Laparoscopy And Endoscopy Cooperative Surgery Versus Traditional Gastrectomy In Gastric Gastrointestinal Stromal Tumors: A Meta-analysis

Background: Gastrointestinal stromal tumor(GIST)is the most common mesenchymal tumor of the gastrointestinal(GI)system,and it has potential malignant biological behavior.Because lymph node metastases are extremely rare,complete surgical resection remains the most effective treatment option for GIST.With the development of gastroscopy and laparoscopy technology,more and more scholars pay attention to laparoscopy and endoscopy cooperative surgery(LECS).Methods: EMBASE,Pub Med,Web of Science,and the Cochrane Library were systematically searched to retrieve studies describing GIST surgery in order to compare outcomes following LECS and traditional gastrectomy.A total of 1852 patients from 25 studies were included in the meta-analysis.All studies were analyzed using Review Manager 5.3 software.Dichotomous results are expressed as odds ratios(ORs)with 95%confidence intervals(CIs)and continuous outcomes are expressed as weighted mean differences(WMDs)with 95%CIs.Result: The meta-analysis showed no significant differences between LECS(Experiment)and traditional gastrectomy(Control)in terms of operation time.The result also showed LECS had the advantages of less bleeding during operation(WMD=-36.06,95%CI:-43.49～-28.62,P<0.05),length of hospital stay(WMD=-3.49,95%CI:-4.20～-2.78,P<0.05),time to flatus(WMD=-0.99,95%CI:-1.22～-0.75,P<0.05),postoperative complications(OR=0.26,95%CI:0.18～0.37,P<0.05)and tumor recurrence(OR=0.33,95%CI:0.12～0.97,P<0.05).Conclusion: LECS is an effective strategy for GIST.