| Objective: Compare the clinical effects of thoracolaparoscopic esophagectomy with cervical anastomosis(TLE) and open three-field esophagectomy(OE) in treating esophageal cancer with the method of system assessment with the aim to provide references for clinical radical surgery for esophageal carcinoma. Methods: Retrieve based on computer Chinese Journal Full-text Database(CNKI); VIP Database;Wanfang Database, Chinese biological and medical database(CBM), PubMed, Science Direct, Web of Science to search clinical comparison and research literature on TLE and OE in treating esophageal cancer. Software Reviw Manager 5.3 was adopted for Meta analysis. Results: Altogether 14 documents meeting the criteria were selected, including 2479 cases, among which 1319 cases were in TLE group(the treatment group) and 1160 cases in OE group(the control group). Meta analysis results show that: compared with the control group, the treatment group has less blood loss volume(MD=-109.09, 95%CI:-144.41~73.76, P<0.05), less postoperative drainage flow(MD=-437.14, 95%CI:-814.47~-58.81, P<0.05), low occurrence rate of pulmonary complications(OR=0.61, 95%CI:0.48~0.76, P<0.05), low occurrence rate of postoperation delayed gastric emptying(OR=0.45, 95%CI:0.22~0.92, P<0.05), low death rate at perioperative period(OR=0.35, 95% CI:0.16~0.74, P<0.05), and short hospital stays(MD=-3.86, 95%CI:-5.56~-2.16, P<0.05); Dur-ing the operation of both groups, the number of lymph nodes harvested and comp-lications of anastomotic leakage and chylothorax had no statistical significance(P≥0.05). Conclusions: Short-term curative effects of both surgeries were equivalent, b-ut T-LE had small wound, less postoperation complications, fast recovery and low death rate at perioperative period and other advantages while its operation time, n-umber of lymph node dissection could match with those of OE. However, long-ter-m effects still remain to be studies and verified. |
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