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World Journal of Surgery

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01-03-2020 | Laparoscopy | Scientific Review

Ability of Laparoscopic Gastric Mobilization to Prevent Pulmonary Complications After Open Thoracotomy or Thoracoscopic Esophagectomy for Esophageal Cancer: A Systematic Review and Meta-analysis

Authors: Eisuke Booka, Yasuhiro Tsubosa, Ryoma Haneda, Kenjiro Ishii

Published in: World Journal of Surgery | Issue 3/2020

Abstract

Background

Esophagectomy has a high risk of postoperative morbidity, and pulmonary complications are the most common causes of serious morbidity. Thoracoscopic esophagectomy has been reported to reduce postoperative pulmonary complications; however, it remains unclear whether laparoscopic gastric mobilization can reduce the occurrence of postoperative pulmonary complications after open thoracotomy or thoracoscopic esophagectomy. The present meta-analysis assessed the ability of laparoscopic gastric mobilization to prevent postoperative complications after open thoracotomy or thoracoscopic esophagectomy.

Method

Studies reported between January 2000 and April 2019 in the PubMed and the Cochrane Library databases that analyzed the impact of laparoscopy on postoperative complications were systematically reviewed. In the meta-analysis, data were pooled and the primary outcome was postoperative pulmonary complications. The secondary outcomes were other postoperative complications, operative details, length of hospital stay and postoperative mortality.

Results

A total of 13 studies (1915 patients; 1 randomized trial, 1 prospective study and 11 observational studies) were included. Laparoscopic gastric mobilization after open thoracotomy resulted in significantly reduced postoperative pulmonary complications (OR = 0.47, 95% confidence interval (CI): 0.27–0.82, p = 0.008) and postoperative mortality (OR = 0.49, 95%CI: 0.25–0.94, p = 0.03). Similarly, laparoscopic gastric mobilization after thoracoscopic esophagectomy resulted in significantly reduced postoperative pulmonary complications (OR = 0.56, 95%CI: 0.37–0.84, p = 0.005) and anastomotic leakage (OR = 0.59, 95%CI: 0.39–0.91, p = 0.02).

Conclusions

Laparoscopic gastric mobilization could be recommended for reducing postoperative pulmonary complications after esophagectomy irrespective of the thoracic approach.

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Title: Ability of Laparoscopic Gastric Mobilization to Prevent Pulmonary Complications After Open Thoracotomy or Thoracoscopic Esophagectomy for Esophageal Cancer: A Systematic Review and Meta-analysis
Authors: Eisuke Booka
Yasuhiro Tsubosa
Ryoma Haneda
Kenjiro Ishii
Publication date: 01-03-2020
Publisher: Springer International Publishing
Keywords: Laparoscopy
Esophageal Cancer
Esophagus Resection
Esophageal Cancer
Thoracotomy
Esophagus Resection
Published in: World Journal of Surgery / Issue 3/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05272-9

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Ability of Laparoscopic Gastric Mobilization to Prevent Pulmonary Complications After Open Thoracotomy or Thoracoscopic Esophagectomy for Esophageal Cancer: A Systematic Review and Meta-analysis

Abstract

Background

Method

Results

Conclusions

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Abstract

Background

Method

Results

Conclusions

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