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Review
. 2016 Dec 8;14(1):304.
doi: 10.1186/s12957-016-1062-7.

Minimally invasive oesophagectomy versus open esophagectomy for resectable esophageal cancer: a meta-analysis

Waresijiang Yibulayin  1 , Sikandaer Abulizi  1 , Hongbo Lv  1 , Wei Sun  2
Affiliations
Review

Minimally invasive oesophagectomy versus open esophagectomy for resectable esophageal cancer: a meta-analysis

Waresijiang Yibulayin et al. World J Surg Oncol. .

Abstract

Background: Open esophagectomy (OE) is associated with significant morbidity and mortality. Minimally invasive oesophagectomy (MIO) reduces complications in resectable esophageal cancer. The aim of this study is to explore the superiority of MIO in reducing complications and in-hospital mortality than OE.

Methods: MEDLINE, Embase, Science Citation Index, Wanfang, and Wiley Online Library were thoroughly searched. Odds ratio (OR)/weighted mean difference (WMD) with a 95% confidence interval (CI) was used to assess the strength of association.

Results: Fifty-seven studies containing 15,790 cases of resectable esophageal cancer were included. MIO had less intraoperative blood loss, short hospital stay, and high operative time (P < 0.05) than OE. MIO also had reduced incidence of total complications; (OR = 0.700, 95% CI = 0.626 ~ 0.781, P V < 0.05), pulmonary complications (OR = 0.527, 95% CI = 0431 ~ 0.645, P V < 0.05), cardiovascular complications (OR = 0.770, 95% CI = 0.681 ~ 0.872, P V < 0.05), and surgical technology related (STR) complications (OR = 0.639, 95% CI = 0.522 ~ 0.781, P V < 0.05), as well as lower in-hospital mortality (OR = 0.668, 95% CI = 0.539 ~ 0.827, P V < 0.05). However, the number of harvested lymph nodes, intensive care unit (ICU) stay, gastrointestinal complications, anastomotic leak (AL), and recurrent laryngeal nerve palsy (RLNP) had no significant difference.

Conclusions: MIO is superior to OE in terms of perioperative complications and in-hospital mortality.

Keywords: Complications; Minimally invasive esophagectomy; Mortality; Open esophagectomy.

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Figures

Fig. 1
Fig. 1
Study flow chart explaining the selection of 57 studies included in the meta-analysis
Fig. 2
Fig. 2
Meta-analysis for MIE and total complications
Fig. 3
Fig. 3
Meta-analysis for MIE and pulmonary complications
Fig. 4
Fig. 4
Galbraith plot of MIE and pulmonary complications
Fig. 5
Fig. 5
Begg’s Test of MIE and pulmonary complications
Fig. 6
Fig. 6
Meta-analysis for MIE and Mortality
Fig. 7
Fig. 7
Meta-analysis of MIE and cardiovascular complications
Fig. 8
Fig. 8
Meta-analysis of MIE and STR complications
Fig. 9
Fig. 9
The “trim and fill” method for MIE and pulmonary complications
Fig. 10
Fig. 10
The sensitivity analysis of MIE and pulmonary complications
See this image and copyright information in PMC

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