Abstract:
Objectives To evaluate the clinical efficacy and safety of minimally invasive surgery for esophageal cancer.
Methods We searched the electronic bibliographic databases, including The Cochrane Library, PubMed, EMBASE, CBM, CNKI, VIP and Wanfang databases to assemble the randomized controlled trials (RCTs) of minimally invasive surgery for esophageal cancer. The deadline of the retrieval time was December 2012. Data were extracted and evaluated by two reviewers independently with a designed extraction form. The RevMan 5.0 software was used for meta-analysis on homogeneous studies.
Results 7 clinical trials involving 431 patients were included. The results of meta-analysis showed: ① There was no significant difference between the two groups in the respect of survival rate, recurrence rate and mortality after surgery;② Minimally invasive surgery could reduce intraoperative bloodlossWMD=-175.33 mL, 95%CI(-195.57, -155.09) mL; ③ There was no significant difference between the two groups in the respect of operating time; ④ Minimally invasive surgery could shorten hospital stay WMD =-9.14 days, 95%CI(-16.09, -2.19) days; ⑤ Minimally invasive surgery could reduce the rate of pulmonary infection, anastomotic leakage and vocal cord paralysis; And lung function in minimally invasive surgery was better than traditional thoracotomy.
Conclusion Evidences showed that minimally invasive surgery could decrease intraoperative bloodloss, the time of postoperative stay, the rate of pulmonary infection, anastomotic leakage and vocal cord paralysis. Further RCT is still needed to evaluate the long-term clinical efficacy of minimally invasive surgery.