Effectiveness of Transthoracic Hybrid Minimally Invasive Esophagectomy: A Meta-Analysis
Background Transthoracic hybrid minimally invasive esophagectomy (HMIE) is frequently performed in patients with esophageal cancer. However, no conclusive benefit has been defined for HMIE compared with open esophagectomy (OE) or totally MIE (TMIE). The aim of this meta-analysis is to evaluate the e...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-08-01
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| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2020.1725189 |
| _version_ | 1827817396510916608 |
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| author | Zheng-Dao Wei Han-Lu Zhang Yu-Shang Yang Long-Qi Chen |
| author_facet | Zheng-Dao Wei Han-Lu Zhang Yu-Shang Yang Long-Qi Chen |
| author_sort | Zheng-Dao Wei |
| collection | DOAJ |
| description | Background Transthoracic hybrid minimally invasive esophagectomy (HMIE) is frequently performed in patients with esophageal cancer. However, no conclusive benefit has been defined for HMIE compared with open esophagectomy (OE) or totally MIE (TMIE). The aim of this meta-analysis is to evaluate the effectiveness of HMIE compared with OE and TMIE. Methods PubMed, Embase (via OVID) and Cochrane databases were comprehensively searched for relevant studies up to January 2019. Studies comparing the efficacy of transthoracic HMIE with OE or TMIE were included in this meta-analysis. Results Twenty-nine relevant studies comprising 3994 patients were identified and included in the analysis of HMIE vs OE. HMIE decreased the incidence of postoperative total morbidity (OR = 0.66, 95% CI 0.55 to 0.80, p = 0.00), pneumonia (OR = 0.55, 95% CI 0.45 to 0.66, p = 0.00), in-hospital mortality (OR = 0.54, 95% CI 0.36 to 0.83, p = 0.01), duration of hospitalization (SMD=-1.03, 95% CI -1.73 to -0.33, p = 0.00) and the estimated intraoperative blood loss (SMD=-1.01, 95% CI -1.62 to -0.40, p = 0.00) compared with OE. Twenty-one relevant studies comprising 3007 patients were identified and included in the analysis of HMIE vs TMIE. HMIE increased estimated intraoperative blood loss [standardized mean difference (SMD) = 1.02, 95% CI 0.45 to 1.58, p = 0.00] and the incidence of postoperative pneumonia (OR = 1.69, 95% CI 1.26 to 2.26, p = 0.00) compared with TMIE. No statistical differences were observed for other surgical outcomes. Conclusions In our opinion, HMIE is a promising surgical technique. But further RCTs are still needed to confirm the advantages and disadvantages of HMIE mentioned above. |
| first_indexed | 2024-03-12T00:33:41Z |
| format | Article |
| id | doaj.art-f47296a69e6849b4862fddab6d3446c2 |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:33:41Z |
| publishDate | 2021-08-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-f47296a69e6849b4862fddab6d3446c22023-09-15T10:07:32ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532021-08-0134996397310.1080/08941939.2020.17251891725189Effectiveness of Transthoracic Hybrid Minimally Invasive Esophagectomy: A Meta-AnalysisZheng-Dao Wei0Han-Lu Zhang1Yu-Shang Yang2Long-Qi Chen3Medical Office Administration, The General Hospital of Western Theater CommandDepartment of Thoracic Surgery, West China Hospital of Sichuan UniversityDepartment of Thoracic Surgery, West China Hospital of Sichuan UniversityDepartment of Thoracic Surgery, West China Hospital of Sichuan UniversityBackground Transthoracic hybrid minimally invasive esophagectomy (HMIE) is frequently performed in patients with esophageal cancer. However, no conclusive benefit has been defined for HMIE compared with open esophagectomy (OE) or totally MIE (TMIE). The aim of this meta-analysis is to evaluate the effectiveness of HMIE compared with OE and TMIE. Methods PubMed, Embase (via OVID) and Cochrane databases were comprehensively searched for relevant studies up to January 2019. Studies comparing the efficacy of transthoracic HMIE with OE or TMIE were included in this meta-analysis. Results Twenty-nine relevant studies comprising 3994 patients were identified and included in the analysis of HMIE vs OE. HMIE decreased the incidence of postoperative total morbidity (OR = 0.66, 95% CI 0.55 to 0.80, p = 0.00), pneumonia (OR = 0.55, 95% CI 0.45 to 0.66, p = 0.00), in-hospital mortality (OR = 0.54, 95% CI 0.36 to 0.83, p = 0.01), duration of hospitalization (SMD=-1.03, 95% CI -1.73 to -0.33, p = 0.00) and the estimated intraoperative blood loss (SMD=-1.01, 95% CI -1.62 to -0.40, p = 0.00) compared with OE. Twenty-one relevant studies comprising 3007 patients were identified and included in the analysis of HMIE vs TMIE. HMIE increased estimated intraoperative blood loss [standardized mean difference (SMD) = 1.02, 95% CI 0.45 to 1.58, p = 0.00] and the incidence of postoperative pneumonia (OR = 1.69, 95% CI 1.26 to 2.26, p = 0.00) compared with TMIE. No statistical differences were observed for other surgical outcomes. Conclusions In our opinion, HMIE is a promising surgical technique. But further RCTs are still needed to confirm the advantages and disadvantages of HMIE mentioned above.http://dx.doi.org/10.1080/08941939.2020.1725189esophageal neoplasmsesophagectomyminimally invasive surgery |
| spellingShingle | Zheng-Dao Wei Han-Lu Zhang Yu-Shang Yang Long-Qi Chen Effectiveness of Transthoracic Hybrid Minimally Invasive Esophagectomy: A Meta-Analysis Journal of Investigative Surgery esophageal neoplasms esophagectomy minimally invasive surgery |
| title | Effectiveness of Transthoracic Hybrid Minimally Invasive Esophagectomy: A Meta-Analysis |
| title_full | Effectiveness of Transthoracic Hybrid Minimally Invasive Esophagectomy: A Meta-Analysis |
| title_fullStr | Effectiveness of Transthoracic Hybrid Minimally Invasive Esophagectomy: A Meta-Analysis |
| title_full_unstemmed | Effectiveness of Transthoracic Hybrid Minimally Invasive Esophagectomy: A Meta-Analysis |
| title_short | Effectiveness of Transthoracic Hybrid Minimally Invasive Esophagectomy: A Meta-Analysis |
| title_sort | effectiveness of transthoracic hybrid minimally invasive esophagectomy a meta analysis |
| topic | esophageal neoplasms esophagectomy minimally invasive surgery |
| url | http://dx.doi.org/10.1080/08941939.2020.1725189 |
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