A Meta-analysis Of Esophagectomy:the Comparative Study Of Ivor-Lewis Operation And Sweet Operation

Objective:To investigate the best surgical resection of esophageal cancer by comparing the efficacy and safety between Ivor-Lewis esophagectomy and Sweet esophagectomy.Methods:The relevant literatures comparing Ivor-Lewis esophagectomy with Sweet esophagectomy were searched through PubMed, Embase, the Cochrane Library, Google scholar, CNKI,CBM, VIP, WanFang Data. RevMan5.3 software was used for data analysis. Results:A total of 3922 patients in 14 studies were reviewed and the data were pooled for analysis. Meta-analysis showed that, compared with the Sweet group, Ivor-Lewis operative time was significantly longer (pooled mean difference^ 57.40,95%CI:42.43 to 72.38, P=0.000), operative bleeding was significantly higher (pooled mean difference=28.39,95%CI:4.06 to 52.72, P=0.02), the number of lymph node dissection significantly more (pooled mean difference=4.19,95%CI:3.06 to 5.32, P=0.000);No significant difference was present in vocal cord paralysis, chylous leakage, pulmonary complications, anastomotic leakage (all P>0.05). The 5-year survival between the two groups showed no significant difference (P=0.60). Conclusions:The two kinds of operation have the same long term effect. Compared with Ivor-Lewis operation, Sweet operation is easier to perform, less time consuming and more tolerable. Ivor-Lewis operation can dissect more lymph nodes than Sweet operation, without increased complications.