Transthoracic vs transhiatal surgery for cancer of the esophagogastric junction: a meta-analysis.
World J Gastroenterol
; 20(29): 10183-92, 2014 Aug 07.
Article
em En
| MEDLINE
| ID: mdl-25110447
ABSTRACT
AIM:
To compare the efficacy and safety of the transthoracic and transhiatal approaches for cancer of the esophagogastric junction.METHODS:
An electronic and manual search of the literature was conducted in PubMed, EmBase and the Cochrane Library for articles published between March 1998 and January 2013. The pooled data included the following parameters duration of surgical time, blood loss, dissected lymph nodes, hospital stay time, anastomotic leakage, pulmonary complications, cardiovascular complications, 30-d hospital mortality, and long-term survival. Sensitivity analysis was performed by excluding single studies.RESULTS:
Eight studies including 1155 patients with cancer of the esophagogastric junction, with 639 patients in the transthoracic group and 516 in the transhiatal group, were pooled for this study. There were no significant differences between two groups concerning surgical time, blood loss, anastomotic leakage, or cardiovascular complications. Dissected lymph nodes also showed no significant differences between two groups in randomized controlled trials (RCTs) and non-RCTs. However, we did observe a shorter hospital stay (WMD = 1.92, 95%CI 1.63-2.22, P < 0.00001), lower 30-d hospital mortality (OR = 3.21, 95%CI 1.13-9.12, P = 0.03), and decreased pulmonary complications (OR = 2.95, 95%CI 1.95-4.45, P < 0.00001) in the transhiatal group. For overall survival, a potential survival benefit was achieved for type III tumors with the transhiatal approach.CONCLUSION:
The transhiatal approach for cancers of the esophagogastric junction, especially types III, should be recommended, and its long-term outcome benefits should be further evaluated.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Gástricas
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Neoplasias Esofágicas
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Esofagectomia
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Procedimentos Cirúrgicos Torácicos
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Junção Esofagogástrica
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Gastrectomia
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
World J Gastroenterol
Ano de publicação:
2014
Tipo de documento:
Article