Meta-analysis Of Randomised Controlled Trials For Route Of Reconstruction After Esophagectomy For Cancer

Objective.-To evaluate the effects of route of reconstruction on patient outcomes after esophagectomy fou cancer.Methods:CBM、VIP、CNKI、Cochrane Library、Pubmed and Embase etc were searched by computer since the establishment of these datebases to December 2012. We also traced related references and experts in this field. As well as communicated with other authors to obtain certain informations that had not been found.Randomized and quasi-randomized controlled trials compared route of gastric conduit reconstruction after esophagectomy for cancer were included. The statistical software RevMan 5.0 was used.Results: 11 published articals were included (998 patients),3 Chinese articls,8 English articles.The results of Meta-analysis showed that compared with retrosternal route, posterior mediastinal route reduce the rates of anastomotic leaks and anastomotic strictures, the OR(95%CI) and P values were OR=0.52,95% CI=0.33-0.82, P=0.005) and (OR=0.40,95%CI=0.25-0.66, P<0.01) respectively. There is no any difference in operative mortality, cardiac complications and pulmonary complications for the two routes of reconstruction, the OR(95%CI) were 0.50 (0.24-1.04), P=0.06; 0.98 (0.58～1.65), P=0.93; 0.97 (0.27～3.39), P=.96 respectively. Conclusion:Compared with retrosternal route, posterior route of reconstruction reduce the rates of anastomotic leaks and anastomotic strictures.