Comparison of the clinical outcomes after esophagectomy between intrathoracic anastomosis and cervical anastomosis: a systematic review and meta-analysis

Autor: Qi-Yue Ge, Yu-Heng Wu, Zhuang-Zhuang Cong, Yong Qiang, Yan-Qing Wang, Chao Zheng, Yi Shen
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: BMC Surgery, Vol 22, Iss 1, Pp 1-13 (2022)
Druh dokumentu: article
ISSN: 1471-2482
DOI: 10.1186/s12893-022-01875-7
Popis: Abstract Objectives Esophageal cancer is a high-mortality disease. Esophagectomy is the most effective method to treat esophageal cancer, accompanied with a high incidence of post-operation complications. The anastomosis has a close connection to many severe post-operation complications. However, it remains controversial about the choice of intrathoracic anastomosis (IA) or cervical anastomosis (CA). The study was conducted to compare the clinical outcomes between the two approaches. Methods We searched databases for both randomized controlled trials (RCTs) and cohort studies comparing post-operation outcomes between IA and CA. Primary outcomes were the incidences of anastomotic leakage and mortality. Secondary outcomes were the incidences of anastomotic stenosis, pneumonia and re-operation. Results Twenty studies with a total of 7,479 patients (CA group: n = 3,183; IA group: n = 4296) were included. The results indicated that CA group had a higher incidence of anastomotic leakage than IA group (odds ratio [OR] = 2.05, 95% confidence intervals [CI] = 1.61–2.60, I2 = 53.31%, P
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