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Review
. 2015 May 8:10:67.
doi: 10.1186/s13019-015-0271-4.

Comparison of two different mechanical esophagogastric anastomosis in esophageal cancer patients: a meta-analysis

Dong Zhou  1 , Quan-Xing Liu  2 , Xu-Feng Deng  3 , Jia-Xin Min  4 , Ji-Gang Dai  5
Affiliations
Review

Comparison of two different mechanical esophagogastric anastomosis in esophageal cancer patients: a meta-analysis

Dong Zhou et al. J Cardiothorac Surg. .

Abstract

Objective: In this meta-analysis, we conducted a pooled analysis of clinical studies comparing Linear Stapled (LS) versus Circular Stapled (CS) esophagogastric anastomosis for esophageal cancer.

Methods: According to the recommendations of the Cochrane Collaboration, we established a rigorous study protocol. We performed a systematic electronic search of the PubMed, Embase, Cochrane Library, Web of Science, and Chinese Biomedical databases as well as Chinese scientific journals to identify articles to include in our meta-analysis. The primary outcomes compared were anastomotic leak, anastomotic stricture and 3-month mortality.

Results: Five controlled trials comprising 840 patients (523 LS vs. 317 CS) were included. Primary outcomes revealed a statistically significant decrease in anastomotic strictures [risk ratio (RR): 0.26, 95 % confidence interval (CI): 0.11-0.60, P = 0.002] compared with linear stapled anastomosis. However, there were no significant differences between the two groups with respect to anastomotic leakage [risk ratio (RR): 0.80, 95 % confidence interval (CI): 0.40-1.58, P = 0.52] and 3-month mortality [risk ratio (RR): 0.94, 95 % confidence interval (CI): 0.47-1.87, P = 0.85].

Conclusion: There were no statistical differences in the rate of 3-month mortality or anastomotic leakage between the two groups. However, the LS method contributed to a reduced rate of anastomotic strictures. This meta-analysis may offer some specific suggestions for esophagogastric anastomosis.

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Figures

Fig. 1
Fig. 1
Flow chart of the literature search according to the PRISMA statement
Fig. 2
Fig. 2
Forest plot for anastomotic strictures. Five studies were included
Fig. 3
Fig. 3
Forest plot for anastomotic leakage. Five studies were included
Fig. 4
Fig. 4
Forest plot for 3-month mortality. Three studies were included
See this image and copyright information in PMC

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