Minimally invasive esophagectomy versus open esophagectomy: A systematic review and meta-analysis

被引:25
作者
Coelho, Francisca dos S. [1 ]
Barros, Diana E. [1 ]
Santos, Filipa A. [1 ]
Meireles, Flavia C. [1 ]
Maia, Francisca C. [1 ]
Trovisco, Rita A. [1 ]
Machado, Teresa M. [1 ]
Barbosa, Jose A. [1 ,2 ]
机构
[1] Univ Porto, Fac Med, Alameda Prof Hernani Monteiro, P-4200319 Porto, Portugal
[2] Ctr Hosp Univ Sao Joao, Serv Cirurgia, EPE, Alameda Prof Hernani Monteiro, P-4200319 Porto, Portugal
来源
EJSO | 2021年 / 47卷 / 11期
关键词
Minimally invasive esophagectomy; Open esophagectomy; Esophageal cancer; QUALITY-OF-LIFE; SURGICAL COMPLICATIONS; OUTCOMES; CLASSIFICATION; RESECTION;
D O I
10.1016/j.ejso.2021.06.012
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The paradigm of the treatment of esophageal cancer has been changing with the increasing use of minimally invasive esophagectomy (MIE) in detriment of open esophagectomy (OE). We aimed to perform a meta-analysis to evaluate and compare these two techniques in terms of mortality and associated complications. The literature search was conducted in MEDLINE and U.S. National Library of Medicine Clinical Trials, considering eligible articles since 2015 to 2020. Clinical trials and observational studies were included. We presented results as mean differences with 95% confidence intervals and calculation of heterogeneity associated to the included studies. Thirty-one articles were included with a total of 34,465 participants diagnosed with esophageal adenocarcinoma or squamous cell carcinoma. MIE had tendency towards a decrease in 30-and 90-day mortality after surgery, but no statistically significative results were found. Major cardiovascular and respiratory complications were less frequent in the MIE group, despite high heterogeneity. Also, MIE might contribute to a decrease of minor post-operative complications, to an increase need of a second surgical intervention, to a greater risk for vocal cord lesions; but these results were not statistically significant. Additionally, no differences were found concerning risk of wound infection and for local and systemic recurrence. MIE may be more beneficial than OE, but these findings should be considered carefully. (c) 2021 Elsevier Ltd, BASO -The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
引用
收藏
页码:2742 / 2748
页数:7
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