Comparison of Efficacy Between Transabdominal and Transthoracic Surgical Approaches for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta-Analysis
BackgroundThe optimal surgical approach, whether transabdominal (TA) or transthoracic (TT), for Siewert type II adenocarcinoma of the esophagogastric junction (AEG) remains controversial. This study compares the efficacy of TA and TT surgical approaches for Siewert type II AEG.MethodsStudies compari...
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.813242/full |
| _version_ | 1818014999989190656 |
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| author | Zonglin Li Huaiwu Jiang Huaiwu Jiang Jin Chen Yifan Jiang Yi Liu Linxia Xu |
| author_facet | Zonglin Li Huaiwu Jiang Huaiwu Jiang Jin Chen Yifan Jiang Yi Liu Linxia Xu |
| author_sort | Zonglin Li |
| collection | DOAJ |
| description | BackgroundThe optimal surgical approach, whether transabdominal (TA) or transthoracic (TT), for Siewert type II adenocarcinoma of the esophagogastric junction (AEG) remains controversial. This study compares the efficacy of TA and TT surgical approaches for Siewert type II AEG.MethodsStudies comparing the surgical and oncological outcomes of TA and TT surgical approaches for Siewert type II AEG up to June 2021 were systematically searched on the Web of Science, PubMed, Embase, and Cochrane Library. A pooled analysis was performed for the available data regarding the baseline features, surgical, and oncological outcomes. The RevMan 5.3 software was used to perform the statistical analysis. Quality evaluation and publication bias were also conducted.ResultsTwelve studies with a total of 2,011 patients, including 985 patients in the TA group and 1,026 patients in the TT group, were included in this study. In the pooled analysis, the surgical outcomes, namely, operative time (MD = −54.61, 95% CI = −123.76 to 14.54, P = 0.12), intraoperative blood loss (MD = −28.85, 95% CI = −71.15 to 13.46, P = 0.18), the number of dissected lymph nodes (MD = 1.90, 95% CI = −1.32 to 5.12, P = 0.25), postoperative complications (OR = 0.84, 95% CI = 0.65 to 1.07, p = 0.16), anastomotic leakage rate (OR = 1.02, 95% CI = 0.63 to 1.65, p = 0.93), and postoperative death rate (OR = 0.89, 95% CI = 0.46 to 1.72, p = 0.73), and the oncological outcomes, namely, overall recurrence rate (OR = 0.75, 95% CI = 0.37 to 1.50, p = 0.41), 3-year overall survival (OS) rate (OR = 1.19, 95% CI = 0.54 to 2.65, p = 0.66), and 5-year OS rate (OR = 1.21, 95% CI = 0.84 to 1.74, p = 0.30) of the two groups were all comparable.ConclusionsBoth TA and TT surgical approaches are appropriate for Siewert type II AEG, and neither has a significant advantage in terms of short- and long-term outcomes. However, more high-quality randomized controlled trials are needed to confirm this conclusion. |
| first_indexed | 2024-04-14T06:51:25Z |
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| id | doaj.art-4d86d6d79c694b9a98ee04607dbb8664 |
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| language | English |
| last_indexed | 2024-04-14T06:51:25Z |
| publishDate | 2022-04-01 |
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| spelling | doaj.art-4d86d6d79c694b9a98ee04607dbb86642022-12-22T02:07:01ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-04-011210.3389/fonc.2022.813242813242Comparison of Efficacy Between Transabdominal and Transthoracic Surgical Approaches for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta-AnalysisZonglin Li0Huaiwu Jiang1Huaiwu Jiang2Jin Chen3Yifan Jiang4Yi Liu5Linxia Xu6Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Gastrointestinal Surgery, Sichuan Mianyang 404 Hospital, Mianyang, ChinaDepartment of Gastrointestinal Surgery, Sichuan Mianyang 404 Hospital, Mianyang, ChinaDepartment of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaBackgroundThe optimal surgical approach, whether transabdominal (TA) or transthoracic (TT), for Siewert type II adenocarcinoma of the esophagogastric junction (AEG) remains controversial. This study compares the efficacy of TA and TT surgical approaches for Siewert type II AEG.MethodsStudies comparing the surgical and oncological outcomes of TA and TT surgical approaches for Siewert type II AEG up to June 2021 were systematically searched on the Web of Science, PubMed, Embase, and Cochrane Library. A pooled analysis was performed for the available data regarding the baseline features, surgical, and oncological outcomes. The RevMan 5.3 software was used to perform the statistical analysis. Quality evaluation and publication bias were also conducted.ResultsTwelve studies with a total of 2,011 patients, including 985 patients in the TA group and 1,026 patients in the TT group, were included in this study. In the pooled analysis, the surgical outcomes, namely, operative time (MD = −54.61, 95% CI = −123.76 to 14.54, P = 0.12), intraoperative blood loss (MD = −28.85, 95% CI = −71.15 to 13.46, P = 0.18), the number of dissected lymph nodes (MD = 1.90, 95% CI = −1.32 to 5.12, P = 0.25), postoperative complications (OR = 0.84, 95% CI = 0.65 to 1.07, p = 0.16), anastomotic leakage rate (OR = 1.02, 95% CI = 0.63 to 1.65, p = 0.93), and postoperative death rate (OR = 0.89, 95% CI = 0.46 to 1.72, p = 0.73), and the oncological outcomes, namely, overall recurrence rate (OR = 0.75, 95% CI = 0.37 to 1.50, p = 0.41), 3-year overall survival (OS) rate (OR = 1.19, 95% CI = 0.54 to 2.65, p = 0.66), and 5-year OS rate (OR = 1.21, 95% CI = 0.84 to 1.74, p = 0.30) of the two groups were all comparable.ConclusionsBoth TA and TT surgical approaches are appropriate for Siewert type II AEG, and neither has a significant advantage in terms of short- and long-term outcomes. However, more high-quality randomized controlled trials are needed to confirm this conclusion.https://www.frontiersin.org/articles/10.3389/fonc.2022.813242/fullAdenocarcinoma of the esophagogastric junction (AEG)Siewert type IItransabdominal (TA)transthoracic (TT)surgical outcomesoncological outcomes |
| spellingShingle | Zonglin Li Huaiwu Jiang Huaiwu Jiang Jin Chen Yifan Jiang Yi Liu Linxia Xu Comparison of Efficacy Between Transabdominal and Transthoracic Surgical Approaches for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta-Analysis Frontiers in Oncology Adenocarcinoma of the esophagogastric junction (AEG) Siewert type II transabdominal (TA) transthoracic (TT) surgical outcomes oncological outcomes |
| title | Comparison of Efficacy Between Transabdominal and Transthoracic Surgical Approaches for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta-Analysis |
| title_full | Comparison of Efficacy Between Transabdominal and Transthoracic Surgical Approaches for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta-Analysis |
| title_fullStr | Comparison of Efficacy Between Transabdominal and Transthoracic Surgical Approaches for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Comparison of Efficacy Between Transabdominal and Transthoracic Surgical Approaches for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta-Analysis |
| title_short | Comparison of Efficacy Between Transabdominal and Transthoracic Surgical Approaches for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta-Analysis |
| title_sort | comparison of efficacy between transabdominal and transthoracic surgical approaches for siewert type ii adenocarcinoma of the esophagogastric junction a systematic review and meta analysis |
| topic | Adenocarcinoma of the esophagogastric junction (AEG) Siewert type II transabdominal (TA) transthoracic (TT) surgical outcomes oncological outcomes |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.813242/full |
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