Neoadjuvant chemoradiotherapy, chemotherapy, and radiotherapy do not significantly increase the incidence of anastomotic leakage after esophageal cancer surgery: a meta-analysis

2021 ◽  
Author(s):  
Zixian Jin ◽  
Jian Zhang ◽  
Dong Chen ◽  
Sikai Wu ◽  
Penglai Xue ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Randomized Controlled Trials ◽  
Anastomotic Leakage ◽  
Meta Analysis ◽  
Neoadjuvant Chemoradiotherapy ◽  
Significant Risk ◽  
Cancer Surgery ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Esophageal Cancer Surgery

Summary This study investigated whether neoadjuvant therapies, such as neoadjuvant chemoradiotherapy (NCRT), neoadjuvant chemotherapy (NCT), and neoadjuvant radiotherapy (NRT), would affect the incidence of anastomotic leakage (AL) after esophageal cancer surgery. Published randomized controlled trials were reviewed, and the incidence of AL after esophageal cancer was statistically analyzed in each study. Meta-analysis was performed using Revman and Stata software. A total of 17 randomized controlled trials with 2874 patients were reviewed showing that, in general, preoperative neoadjuvant therapies were not significant risk factors for AL after esophageal cancer surgery (relative risk [RR] = 0.82, 95% CI = 0.64–1.04). NCRT and NRT did not significantly increase the risk of postoperative AL in patients with esophageal cancer (RR = 0.81, 95% CI = 0.63–1.05; RR = 0.64, 95% CI = 0.14–2.97, respectively). Moreover, NCT has no significant correlation with the occurrence of AL (RR = 1.01, 95% CI = 0.57–1.80). NCRT, NCT, and NRT do not significantly increase the incidence of gastroesophageal AL after esophageal cancer surgery.

scholarly journals Perioperative immunonutrition in esophageal cancer patients undergoing esophagectomy: the first meta-analysis of randomized clinical trials

2020 ◽  
Vol 33 (4) ◽  
Author(s):  
Wang Mingliang ◽  
Ke Zhangyan ◽  
Fan Fangfang ◽  
Wang Huizhen ◽  
Li Yongxiang
Keyword(s):  
Esophageal Cancer ◽  
Randomized Controlled Trials ◽  
Anastomotic Leakage ◽  
Large Scale ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference

Summary Although several randomized controlled trials have been published in recent years, the effect of perioperative immunonutrition in esophageal cancer (EC) patients remains unclear. This initial meta-analysis was conducted to assess whether perioperative enteral immunonutrition reduces postoperative complications in patients undergoing esophagectomy for EC. Relevant randomized controlled trials published before 1st September 2019 were retrieved from the Cochrane Library, PubMed, and EMBASE databases. After the literature was screened, two researchers extracted the information and data from eligible studies according to predefined selection criteria. Obtained data were pooled and analyzed by RevMan 5.3 software. The results were presented as risk ratios (RRs) with 95% confidence intervals (CIs). The heterogeneity among studies was tested by I2 test. Seven high-quality randomized controlled trials were included, with a total of 606 patients, 311 of whom received immunonutrition before and after surgery, while 295 received perioperative standard nutrition. No significant difference was observed between the two groups in the incidence of postoperative infection complications, including total infection complications (RR = 0.97, CI: 0.78–1.20, P = 0.76), pneumonia (RR = 0.97, CI: 0.71–1.33, P = 0.84), wound infection (RR = 0.80, CI: 0.46–1.40, P = 0.44), sepsis (RR = 1.35, CI: 0.67–2.71, P = 0.40), and urinary tract infection (RR = 0.87, CI: 0.54–1.40, P = 0.56). The prevalence of anastomotic leakage in the two groups was 9.4 and 5.4%, but the difference was not statistically significant (RR = 0.59, CI: 0.33–1.04, P = 0.07). Perioperative enteral immunonutrition provided no benefit in terms of the incidence of infection complications and anastomotic leakage in EC patients undergoing esophagectomy. Further large-scale randomized controlled trials are needed to confirm this conclusion.

scholarly journals Comparison of Postoperative Complications Between Robotic and Laparoscopic Rectal Cancer Surgery

2020 ◽  
Author(s):  
Tang bo ◽  
xiong lei ◽  
junhua ai ◽  
zhixiang huang ◽  
jun shi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Postoperative Complications ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Controlled Trials ◽  
Respiratory Complications ◽  
Perioperative Mortality ◽  
Randomized Controlled

Abstract Objective: Robotic and laparoscopic surgery for rectal cancer have been applied in clinic for decades, nevertheless, which surgical approach has a lower rate of postoperative complications is still inconclusive. Therefore, the aim of this meta-analysis is to compare the postoperative complications between robotic and laparoscopic rectal cancer surgery based on randomized controlled trials.Methods: Randomized controlled trials (until May 2020) which compared robotic and laparoscopic rectal cancer surgery were searched through PubMed, EMbase, Cochrane library, CNKI, Wan Fang databases and CBM. Data regarding sample size, clinical and demographic characteristics, overall postoperative complications, and the incidence of anastomotic leakage、incision infection、bleeding、 ileus、respiratory complications、 urinary complications、unscheduled reoperation 、perioperative mortality were extracted. The results were analyzed using RevMan v5.3.Results: Seven randomized controlled trials which included 507 robotic and 516 laparoscopic rectal cancer surgery cases were included. Meta-analysis showed that the overall postoperative complications [Z=1.1，OR=1.18，95% CI (0.88-1.57), P=0.27], anastomotic leakage [Z=0.96, OR=1.27, 95% CI (0.78-2.08), P=0.34], incision infection [Z=0.18, OR=1.05, 95% CI (0.61-1.79), P=0.86], bleeding [Z=0.19, OR=0.89, 95% CI (0.27-2.97), P=0.0.85], ileus [Z=1.47, OR=0.66, 95% CI (0.38-1.15), P=0.14], respiratory complications [Z=0.84, OR=0.64, 95% CI (0.22-1.82), P=0.40], urinary complications [Z=0.66, OR=1.22, 95% CI (0.67-2.22),P=0.51], unscheduled reoperation [Z=0.14, OR=0.91, 95% CI (0.26-3.20), P=0.89], perioperative mortality [Z=0.28, OR=0.79, 95% CI (0.15-4.12), P=0.78] were similar between robotic and laparoscopic rectal surgery.Conclusion: Robotic surgery for rectal cancer was comparable to laparoscopic surgery with respect to postoperative complications.

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