Network meta-analysis of randomized controlled trials on esophagectomies in esophageal cancer: The superiority of minimally invasive surgery.
Esophageal cancer
Esophagectomy
Laparoscopy
Minimally invasive
Network meta-analysis
Surgery
Journal
World journal of gastroenterology
ISSN: 2219-2840
Titre abrégé: World J Gastroenterol
Pays: United States
ID NLM: 100883448
Informations de publication
Date de publication:
14 Aug 2022
14 Aug 2022
Historique:
received:
16
01
2022
revised:
26
04
2022
accepted:
16
07
2022
entrez:
26
9
2022
pubmed:
27
9
2022
medline:
28
9
2022
Statut:
ppublish
Résumé
Previous meta-analyses, with many limitations, have described the beneficial nature of minimal invasive procedures. To compare all modalities of esophagectomies to each other from the results of randomized controlled trials (RCTs) in a network meta-analysis (NMA). We conducted a systematic search of the MEDLINE, EMBASE, We included 11 studies in our analysis. We found a significant difference in postoperative pulmonary infection, which favored the minimally invasive intervention compared to transthoracic surgery (risk ratio 0.49; 95%CI: 0.23 to 0.99). The operation time was significantly shorter for the transhiatal approach compared to transthoracic surgery (mean difference -85 min; 95%CI: -150 to -29), hybrid intervention (mean difference -98 min; 95%CI: -190 to -9.4), minimally invasive technique (mean difference -130 min; 95%CI: -210 to -50), and robot-assisted esophagectomy (mean difference -150 min; 95%CI: -240 to -53). Other comparisons did not yield significant differences. Based on our results, the implication of minimally invasive esophagectomy should be favored.
Sections du résumé
BACKGROUND
BACKGROUND
Previous meta-analyses, with many limitations, have described the beneficial nature of minimal invasive procedures.
AIM
OBJECTIVE
To compare all modalities of esophagectomies to each other from the results of randomized controlled trials (RCTs) in a network meta-analysis (NMA).
METHODS
METHODS
We conducted a systematic search of the MEDLINE, EMBASE,
RESULTS
RESULTS
We included 11 studies in our analysis. We found a significant difference in postoperative pulmonary infection, which favored the minimally invasive intervention compared to transthoracic surgery (risk ratio 0.49; 95%CI: 0.23 to 0.99). The operation time was significantly shorter for the transhiatal approach compared to transthoracic surgery (mean difference -85 min; 95%CI: -150 to -29), hybrid intervention (mean difference -98 min; 95%CI: -190 to -9.4), minimally invasive technique (mean difference -130 min; 95%CI: -210 to -50), and robot-assisted esophagectomy (mean difference -150 min; 95%CI: -240 to -53). Other comparisons did not yield significant differences.
CONCLUSION
CONCLUSIONS
Based on our results, the implication of minimally invasive esophagectomy should be favored.
Identifiants
pubmed: 36157121
doi: 10.3748/wjg.v28.i30.4201
pmc: PMC9403425
doi:
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
4201-4210Informations de copyright
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
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