Systematic review of minimally invasive resection for gastro-oesophageal cancer

Background: This article reviews the evidence on the safety and efficacy of minimally invasive surgery for gastric and oesophageal cancer. Methods: An electronic search of the literature between 1997 and 2007 was undertaken to identify primary studies and systematic reviews; studies were retrieved and analysed using predetermined criteria. Information on the safety and efficacy of minimally invasive surgery for gastric and oesophageal cancer was recorded and analysed. Results: From 188 abstracts reviewed, 46 eligible studies were identified, 23 on oesophagectomy and 23 on gastrectomy. There were 35 case series, eight case-matched studies and three randomized controlled trials. Compared with the contemporary results of open surgery, reports on minimally invasive surgery indicate potentially favourable outcomes in terms of operative blood loss, recovery of gastrointestinal function and hospital stay. However, the quality of the data was generally poor, with many potential sources of bias. Conclusions: Minimally invasive surgery is feasible but evidence of benefit is currently weak.