Comparison of outcomes between minimally invasive oesophagectomy and open oesophagectomy for oesophageal cancer

Abstract

Background: A systematic review with meta-analysis was performed to compare perioperative outcomes between minimally invasive oesophagectomy (MIE) and open oesophagectomy (OE).

Methods: PubMed and Cochrane databases were searched up to January 2015 using keywords: esophageal cancer, MIE, OE, hybrid MIE. Randomized controlled trials or prospective studies comparing the efficacy of OE with MIE or hybrid MIE in oesophageal cancer patients were included. Sensitivity analysis and quality assessment were performed.

Results: MIE required longer operation time (pooled standardized difference in means = 0.565; 95% confidence interval (CI) = 0.272, 0.858; P < 0.001) than OE, but resulted in less blood loss, shorter hospital stays, lower incidence of pneumonia and vocal cord palsy (P values ≤0.026). There was no difference between MIE and OE regarding lymph node yield (pooled standardized difference in means = 0.078; 95% CI = -0.111, 0.267; P = 0.419). Length of intensive care unit stay, in-hospital mortality and 30-day mortality were also similar (P values ≥0.419) in both groups.

Conclusions: Regarding certain clinical outcomes, MIE may be more beneficial than OE.

Keywords: minimally invasive oesophagectomy; oesophageal cancer; open oesophagectomy.