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Erschienen in: World Journal of Surgery 3/2020

13.11.2019 | 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

verfasst von: Eisuke Booka, Yasuhiro Tsubosa, Ryoma Haneda, Kenjiro Ishii

Erschienen in: World Journal of Surgery | Ausgabe 3/2020

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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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Metadaten
Titel
Ability of Laparoscopic Gastric Mobilization to Prevent Pulmonary Complications After Open Thoracotomy or Thoracoscopic Esophagectomy for Esophageal Cancer: A Systematic Review and Meta-analysis
verfasst von
Eisuke Booka
Yasuhiro Tsubosa
Ryoma Haneda
Kenjiro Ishii
Publikationsdatum
13.11.2019
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 3/2020
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-05272-9

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