Minimally invasive esophagectomy versus open esophagectomy: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Francisca dos S. Coelho ◽  
Diana E. Barros ◽  
Filipa A. Santos ◽  
Flávia C. Meireles ◽  
Francisca C. Maia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Meta Analysis ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy

Minimally invasive oesophagectomy in the prone versus lateral decubitus position: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Dimitrios Schizas ◽  
Dimitrios Papaconstantinou ◽  
Anastasia Krompa ◽  
Antonios Athanasiou ◽  
Tania Triantafyllou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Meta Analysis ◽  
Lateral Decubitus Position ◽  
Prone Positioning ◽  
Respiratory Complications ◽  
Invasive Esophagectomy ◽  
Postoperative Respiratory Complications ◽  
Lateral Decubitus

Abstract The thoracic phase of minimally invasive esophagectomy was initially performed in the lateral decubitus position (LDP); however, many experts have gradually transitioned to a prone position (PP) approach. The aim of the present systematic review and meta-analysis is to quantitatively compare the two approaches. A systematic literature search of the MEDLINE, Embase, Google Scholar, Web of Knowledge, China National Knowledge Infrastructure and ClinicalTrials.gov databases was undertaken for studies comparing outcomes between patients undergoing minimally invasive esophageal surgery in the PP versus the LDP. In total, 15 studies with 1454 patients (PP; n = 710 vs. LDP; n = 744) were included. Minimally invasive esophagectomy in the PP provides statistically significant reduction in postoperative respiratory complications (Risk ratios 0.5, 95% confidence intervals [CI] 0.34–0.76, P < 0.001), blood loss (weighted mean differences [WMD] –108.97, 95% CI –166.35 to −51.59 mL, P < 0.001), ICU stay (WMD –0.96, 95% CI –1.7 to −0.21 days, P = 0.01) and total hospital stay (WMD –2.96, 95% CI –5.14 to −0.78 days, P = 0.008). In addition, prone positioning increases the overall yield of chest lymph node dissection (WMD 2.94, 95% CI 1.54–4.34 lymph nodes, P < 0.001). No statistically significant difference in regards to anastomotic leak rate, mortality and 5-year overall survival was encountered. Subgroup analysis revealed that the protective effect of prone positioning against pulmonary complications was more pronounced for patients undergoing single-lumen tracheal intubation. A head to head comparison of minimally invasive esophagectomy in the prone versus the LDP reveals superiority of the former method, with emphasis on the reduction of postoperative respiratory complications and reduced length of hospitalization. Long-term oncologic outcomes appear equivalent, although validation through prospective studies and randomized controlled trials is still necessary.

scholarly journals McKeown or Ivor Lewis totally minimally invasive esophagectomy for cancer of the esophagus and gastroesophageal junction: systematic review and meta-analysis

2017 ◽  
Vol 9 (S8) ◽  
pp. S826-S833 ◽  
Author(s):  
Frans van Workum ◽  
Gijs H. Berkelmans ◽  
Bastiaan R. Klarenbeek ◽  
Grard A. P. Nieuwenhuijzen ◽  
Misha D. P. Luyer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Meta Analysis ◽  
Gastroesophageal Junction ◽  
Ivor Lewis ◽  
Invasive Esophagectomy ◽  
Cancer Of The Esophagus ◽  
Esophagectomy For Cancer

scholarly journals Long-term oncological outcomes following completely minimally invasive esophagectomy versus open esophagectomy

2020 ◽  
Vol 33 (6) ◽  
Author(s):  
K Patel ◽  
A Askari ◽  
K Moorthy
Keyword(s):  
Minimally Invasive ◽  
Odds Ratio ◽  
Minimally Invasive Esophagectomy ◽  
Meta Analysis ◽  
Surgical Trauma ◽  
Cochrane Central Register ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy ◽  
Oncological Outcomes

Summary Open esophagectomy (OE) for esophageal and gastroesophageal junctional cancers is associated with high morbidity. Completely minimally invasive esophagectomy (CMIE) techniques have evolved over the last two decades and significantly reduce surgical trauma compared to open surgery. Despite this, long-term oncological outcomes following CMIE compared to OE remain unclear. This systematic review and meta-analysis aimed to compare overall 5-year survival (OFS) and disease-free 5-year survival (DFFS) between CMIE and OE. It was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive electronic literature search from MEDLINE, EMBASE, Web of Science, Scopus and the Cochrane Central Register of Controlled Trials was conducted. The PROSPERO database was also searched for studies comparing OFS and DFFS between CMIE and OE. The Newcastle Ottawa Scale was used to assess study quality for included studies. Overall, seven studies (containing 949 patients: 527 OE and 422 CMIE) were identified from screening. On pooled meta-analysis, there was no significant difference in OFS or DFFS between CMIE and OE cohorts ([odds ratio 1.12; 95% CI: 0.85 to 1.48; P = 0.41] and [odds ratio 1.34; 95% CI: 0.81–2.22; P = 0.25] respectively). Sensitivity and subgroup analysis with high-quality studies, three highest sample sized studies, and three most recent studies also revealed no difference in long-term oncological outcomes between the two operative groups. This review demonstrates long-term oncological outcomes following CMIE appear equivalent to OE based on amalgamation of existing published literature. Limited high-level evidence comparing OFS and DFFS between CMIE and OE exists. Further research with a randomized controlled trial is required to clinically validate these findings.

scholarly journals Postoperative hiatal herniation after open vs. minimally invasive esophagectomy; a systematic review and meta-analysis

2021 ◽  
Vol 93 ◽  
pp. 106046
Author(s):  
Himam Murad ◽  
Biying Huang ◽  
Nelson Ndegwa ◽  
Ioannis Rouvelas ◽  
Fredrik Klevebro
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Meta Analysis ◽  
Invasive Esophagectomy
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