Open and minimally invasive surgery for gastrointestinal stromal tumours: a systematic review and network meta-analysis protocol

Abstract

IntroductionGastrointestinal 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 analysisPubMed, 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 disseminationNo 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 numberCRD42021237892.

What are the factors predictive of postoperative complications in patients with colorectal cancer undergoing stenting as a bridge to surgery?

“…In Table 1, I think the following factors need to be included in the study because they may be related to postoperative complications. [2][3][4][5] Second, in Table 1, I think the preoperative diseases of two groups need to be included in the study, such as lung disease, cardiovascular disease, and diabetes. Patients with chronic obstructive pulmonary disease are prone to respiratory depression during and after the operation, which can increase the risk of postoperative pulmonary infection.…”

Gastrointestinal Stromal Tümörlerin Kliniko-patolojik ve Cerrahi Özellikleri: 13 yıllık 3.Basamak Merkezi Deneyimi ve Literatür Derlemesi

“…Ancak, ş md ye kadar standart b r terapot k yaklaşım hakkında f k r b rl ğ yoktur. GIST cerrah s nde genel olarak komplet cerrah rezeks yon yapı-lab ld ğ sürece, m n mal nvaz f cerrah g derek popülar te kazanmaktadır [15][16][17]. Uygun end kasyonlarda ve yeterl deney m varlığında, lokal zasyon ve r sk grubundan bağımsız olarak laparoskop öner lmekted r 18,19.…”