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Open versus hybrid versus totally minimally invasive Ivor Lewis esophagectomy: Systematic review and meta-analysis.
Bras Harriott, Camila; Angeramo, Cristian A; Casas, María A; Schlottmann, Francisco.
Afiliação
  • Bras Harriott C; Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina.
  • Angeramo CA; Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina.
  • Casas MA; Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina.
  • Schlottmann F; Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina; Division of Esophageal and Gastric Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina. Electronic address: fschlottmann@hotmail.com.
J Thorac Cardiovasc Surg ; 164(6): e233-e254, 2022 12.
Article em En | MEDLINE | ID: mdl-35164948
BACKGROUND: Hybrid and minimally invasive approaches have emerged as less invasive alternatives to open Ivor Lewis esophagectomy. The aim of this study was to compare surgical outcomes between open (OE), hybrid (HE), and totally minimally invasive esophagectomy (TMIE). METHODS: A systematic literature search was performed to analyze outcomes after OE, HE, and TMIE with intrathoracic anastomosis. Main outcomes included anastomotic leak rate, overall morbidity, and 30-day mortality. A meta-analysis of proportions was used to assess the effect of each approach on different outcomes. RESULTS: A total of 130 studies comprising 16,053 patients were included for analysis; 8081 (50.3%) underwent OE, 1524 (9.5%) HE, and 6448 (40.2%) TMIE. The risk of anastomotic leak was lower after OE (odds ratio [OR], 0.71; 95% CI, 0.62-0.81; P < .0001). Overall morbidity rate was 45% (95% CI, 38%-52%) after OE, 40% (95% CI, 25%-59%) after HE, and 37% (95% CI, 32%-43%) after TMIE. Risk estimation showed higher odds of postoperative mortality after OE (OR, 2.22; 95% CI, 1.76-2.81; P < .0001) and HE (OR, 1.93; 95% CI, 1.32-2.81; P < .001), compared with TMIE. Median length of hospital stay (LOS) was 14.1 (range, 8-28), 12.5 (range, 8-18), and 11.9 (range, 7-30) days after OE, HE and TMIE, respectively (P = .003). CONCLUSIONS: HE and TMIE are associated with lower rates of overall morbidity, reduced postoperative mortality, and shorter LOS, compared with OE. TMIE is associated with lower mortality rates and shorter LOS than HE. Further efforts are needed to widely embrace TMIE in a safe manner.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Esofágicas / Laparoscopia Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: J Thorac Cardiovasc Surg Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Argentina País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Esofágicas / Laparoscopia Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: J Thorac Cardiovasc Surg Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Argentina País de publicação: Estados Unidos