Digestive Diseases and Sciences

, Volume 55, Issue 11, pp 3031–3040 | Cite as

Minimally Invasive Versus Open Esophagectomy: Meta-Analysis of Outcomes

  • George Sgourakis
  • Ines Gockel
  • Arnold Radtke
  • Thomas J. Musholt
  • Stephan Timm
  • Andreas Rink
  • Achilleas Tsiamis
  • Constantine Karaliotas
  • Hauke Lang
Original Article

Abstract

Background

A meta-analysis of the current literature was performed to compare the perioperative outcome measures and oncological impact between minimally invasive and open esophagectomy.

Methods

Using the electronic databases Medline, Embase, Pubmed and the Cochrane Library, we performed a meta-analysis pooling the effects of outcomes of 1,008 patients enrolled into eight comparative studies, using classic and modern meta-analytic methods.

Results

Two comparisons were considered for this systematic review: (I) open thoracotomy vs. VATS/laparoscopy esophagectomy and (II) open thoracotomy vs. VATS esophagectomy. In comparison I: both procedures report equally comparable outcomes (removed lymph nodes, 30-day mortality, 3-year survival) with the exception of overall morbidity (P = 0.038; in favor of the MIE arm) and anastomotic stricture (P < 0.001; in favor of the open thoracotomy arm). In comparison II: No differences were noted between treatment arms concerning postoperative outcomes and survival.

Conclusions

In summary, both arms were comparable with regard to perioperative results and prognosis. Further prospective comparative or randomized-controlled trials focusing on the oncological impact of MIE are needed.

Keywords

Minimally invasive esophagectomy Open esophagectomy Meta-analysis Evidence based medicine Publication bias Barrett’s esophagus 

Notes

Conflict of interest statement

The authors have no financial or personal relationships with persons or organisations that could inappropriately influence this work.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • George Sgourakis
    • 1
    • 2
  • Ines Gockel
    • 1
  • Arnold Radtke
    • 1
  • Thomas J. Musholt
    • 1
  • Stephan Timm
    • 1
  • Andreas Rink
    • 1
  • Achilleas Tsiamis
    • 3
  • Constantine Karaliotas
    • 2
  • Hauke Lang
    • 1
  1. 1.Department of General and Abdominal SurgeryJohannes Gutenberg University HospitalMainzGermany
  2. 2.2nd Surgical Department and Surgical Oncology UnitKorgialenio–Benakio Red Cross HospitalAthensGreece
  3. 3.Department of Colorectal and Laparoscopic SurgeryJames Paget University HospitalNorfolkUK

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