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Updated: Sep 1, 2025
Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors
Published on: February 19, 2022
Therapeutic Effects of 4 Surgical Approaches for Small Gastrointestinal Stromal Tumors: A Network Meta-analysis
Zhiyuan Yu1,2, Huaiyu Tu2, Chen Liang3
1School of Medicine, Nankai University, Tianjin.
Abstract:
This study aims to systematically evaluate the efficacy of endoscopic resection (ER), laparoscopic resection (LR), laparoscopic endoscopic cooperative surgery (LECS), and open surgery (OpS) for gastrointestinal stromal tumors with small diameters (≤5 cm). Relevant studies were collected through Pubmed, Cochrane Library, and Embase databases. Operative time, hospital stays, time to liquid diet, intraoperative bleeding, and complications were used as outcome indicators for meta-analysis. Twenty-four retrospective cohort studies with 2406 participants were analyzed. LR and OpS groups had longer operating time than the ER group. ER, LECS, and LR groups had decreased lengths of hospital stay than the OpS group. Moreover, patients in LR and LECS groups had fewer complications than those in the OpS group. Endoscopic operation for small gastrointestinal stromal tumors contributes to shortened lengths of surgery and hospital stay. This reduces intraoperative blood loss and promotes gastroenteric functional recovery without increasing the risk of complications or tumor recurrence.
Insights
Endoscopic resection (ER) and similar minimally invasive techniques offer shorter surgery and hospital stays for small gastrointestinal stromal tumors (≤5 cm). These methods improve recovery without raising complication risks.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract.
- Small GISTs (≤5 cm) are often treated with surgical resection, but the optimal approach remains debated.
- Minimally invasive techniques like endoscopic resection (ER), laparoscopic resection (LR), and laparoscopic endoscopic cooperative surgery (LECS) are increasingly utilized.
Purpose of the Study:
- To systematically evaluate and compare the efficacy of ER, LR, LECS, and open surgery (OpS) for small GISTs (≤5 cm).
- To identify the most advantageous surgical approach regarding key perioperative outcomes.
Main Methods:
- A meta-analysis of 24 retrospective cohort studies involving 2406 participants.
- Inclusion of studies from major databases: Pubmed, Cochrane Library, and Embase.
- Outcome indicators included operative time, hospital stay, time to liquid diet, intraoperative bleeding, and complications.
Main Results:
- Endoscopic resection (ER) and laparoscopic resection (LR) showed shorter operating times compared to open surgery (OpS).
- ER, LECS, and LR groups experienced significantly shorter hospital stays than the OpS group.
- LR and LECS groups demonstrated fewer complications compared to OpS.
Conclusions:
- Minimally invasive endoscopic procedures for small GISTs lead to reduced operative and hospital stay durations.
- These approaches promote faster gastrointestinal functional recovery.
- Endoscopic resection, laparoscopic resection, and LECS offer favorable outcomes for small GISTs without increasing complication or recurrence risks.
