Complications in Patients after Side-to-side Esophagogastric Anastomosis: A Systematic Review and Meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HUWen-teng ¹ , CAIQian-qian ¹ , LINRui-jiang ¹ , MAMin-jie ² , WEINing ² , ZHANGYu ² , YANGKan ² ,  HANBiao ²

1. The First Clinical Medical College of Lanzhou University, Lanzhou 730000, P. R. China;
2. The First Hospital of Lanzhou University, Lanzhou 730000, P. R. China;

Corresponding?author：

HANBiao, Email: hanbiao66@msn.com

Keywords：

Esophagogastric anastomosis; Side-to-side anastomosis; Randomized controlled trials; Systematic review/Meta-analysis

DOI：

10.7507/1007-4848.20160054

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Objective To systematically review the impact of side-to-side esophagogastric anastomosis on postoperative anastomostic leak, fibrosis stricture and stroesophageal reflux. Methods We searched PubMed, EMbase, The Cochrane Library (Issue 4 2015), Web of Science, CNKI, CBM, Wanfang Database and VIP up to April 2015. Randomized controlled trials involving the complications after side-to-side esophagogastric anastomosis were included. Data were extracted and methodological quality was evaluated by two reviewers independently with a designed extraction form. Then RevMan 5.3 software was used for meta-analysis. Results A total of 7 studies involving 684 patients were included. The results of meta-analysis showed that comparing with traditional anastomosis, side-to-side esophagogastric anastomosis could reduce the incidence of fibrosis stricture with RR=0.20 and 95% CI 0.11 to 0.36 (P<0.000 01). There was no statistical difference in incidence of postoperative anasotmostic leaks with RR=0.71 and 95% CI 0.43 to 1.19 (P=0.19) or stroesophageal reflux with RR=0.74 and 95% CI 0.50 to 1.11 (P=0.15) between the two groups. Conclusion Comparing with traditional anastomosis, side-to-side esophagogastric anastomosis could reduce the incidences of fibrosis stricture, but there is no statistical difference in anastomostic leak or stroesophageal reflux.

Citation： HUWen-teng, CAIQian-qian, LINRui-jiang, MAMin-jie, WEINing, ZHANGYu, YANGKan, HANBiao. Complications in Patients after Side-to-side Esophagogastric Anastomosis: A Systematic Review and Meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(3): 224-229. doi: 10.7507/1007-4848.20160054 Copy

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2.	Parkin DM. Global cancer statistics in the year 2000. The lancet oncology, 2001, 2(9): 533-543.
3.	Villaflor VM, Allaic ME, Minsky B, et al. Multidisciplinary approach for patients with esophageal cancer. WJG, 2012, 18(46): 6737.
4.	王文憑, 陳龍奇. 食管癌外科治療的現狀與展望. 中國胸心血管外科臨床雜志, 2011, 18(1): 58-65.
5.	Honda M, Kuriyama A, Noma H, et al. Hand-sewn versus mecha-nical esophagogastric anastomosis after esophagectomy: a systematic review and meta-analysis. Ann Surg, 2013, 257(2): 238-248.
6.	Godoy MC, Bruzzi JF, Viswanathan C, et al. Multimodality imaging evaluation of esophageal cancer: staging, therapy assessment, and complications. Abdominal Imaging, 2013, 38(5): 974-993.
7.	Zhou D, Liu QX, Deng XF, et al. Comparison of two different mechanical esophagogastric anastomosis in esophageal cancer patients: a meta-analysis. J Cardiothorac Surg, 2015, 10(1): 67.
8.	張雪飛, 史小男, 韓彪. 機械與手工食管胃吻合術后吻合口瘺發生率比較的系統評價. 中國循證醫學雜志, 2012, 12(11): 1367-1371.
9.	楊列, 鄭軼峰, 姜建青, 等. 不同食管胃吻合方式對術后并發癥影響的Meta分析. 循證醫學, 2013, 13(3): 173-180.
10.	Raz DJ, Tedesco P, Herbella FA, et al. Side-to-side stapled intra-thoracic esophagogastric anastomosis reduces the incidence of leaks and stenosis. Dis Esophagus, 2008, 21(1): 69-72.
11.	Deng XF, Liu QX, Zhou D, et al. Hand-sewn vs linearly stapled esophagogastric anastomosis for esophageal cancer: A meta-analysis. WJG, 2015, 21(15): 4757-4764.
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13.	武玉兵, 張京楠, 孫毅, 等. 食管胃頸部側側全機械性吻合法在食管癌切除中的臨床應用研究. 中國醫藥指南, 2015, (7): 112-112, 113.
14.	余勇, 胡振東,張勤,等. 食管胃胸腔內側側吻合的臨床效果. 江蘇醫藥, 2015, 41(5): 2.
15.	馬忠廈, 徐有望, 代傳宙, 等. 全機械性食管胃頸部側側吻合在食管癌切除術中的應用. 延邊醫學, 2014, (21): 37-38.
16.	胡風標, 鄒志強, 袁耒, 等. 半機械側吻合和手工吻合兩種食管胃頸部吻合術式的療效比較. 中國現代藥物應用, 2013, (14):115-117.
17.	Wang WP, Gao Q, Wang KN, et al. A prospective randomized controlled trial of semi-mechanical versus hand-sewn or circular stapled esophagogastrostomy for prevention of anastomotic stric-ture. World J Surg, 2013, 37(5): 1043-1050.
18.	楊列, 鄭軼峰, 姜建青, 等. 食管癌切除術后頸部食管胃側側吻合與手工端側吻合效果的對照研究. 重慶醫學, 2012, 41(30): 3155-3156,3159.
19.	Saluja SS, Ray S, Pal S, et al. Randomized trial comparing side-to-side stapled and hand-sewn esophagogastric anastomosis in neck. J Gastrointest Surg, 2012, 16(7): 1287-1295.
20.	Egberts JH, Schniewind B, Bestmann B, et al. Impact of the site of anastomosis after oncologic esophagectomy on quality of life-a prospective, longitudinal outcome study. Ann Surg Oncol, 2008, 15(2): 566-575.
21.	Lerut T, Coosemans W, Decker G, et al. Anastomotic complications after esophagectomy. Digest Surg, 2002, 19(2): 92-98.
22.	Akiyama H. Chief editor. Surgery for cancer of the esophagus. Hiroshi Akiyama: Williams & Wilkins; 1990.
23.	龍夢云, 韋詩友, 黃芊, 等. 兩種食管上提徑路對食管癌患者術后并發癥影響的系統評價和Meta分析. 中國胸心血管外科臨床雜志, 2015, 22(2): 91-99.
24.	高旭輝, 劉雷霆, 朱水波, 等食管癌患者食管-管狀胃環形吻合器端側吻合與半器械側側吻合近期治療效果觀察. 臨床外科雜志, 2015, (4): 305-307.
25.	Aly A, Jamieson GG, Watson DI, et al. An antireflux anastomosis following esophagectomy: a randomized controlled trial. J Gastroin-test Surg, 2010, 14(3): 470-475.
26.	Lee J, Anggiansah A, Anggiansah R, et al. Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. Clin Gastroenterology Hepatology, 2007, 5(12): 1392-1398.
27.	Paterson WG. The normal antireflux mechanism. Chest surgery clinics of North America, 2001, 11(3): 473-483.
28.	Cooke DT, Lin GC, Lau CL, et al. Analysis of cervical esophagogas-tric anastomotic leaks after transhiatal esophagectomy: risk factors, presentation, and detection. Ann Thorac Surg, 2009, 88(1): 177-185.
29.	Aly A, Jamieson G, Pyragius M, et al. Antireflux anastomosis following oesophagectomy. ANZ J Surg, 2004, 74(6): 434-438.

1. Siefel R, Miller K, Jemaal A. Cancer statistics. CA Cancer J Clin, 2015, 65: 5-29.22.
2. Parkin DM. Global cancer statistics in the year 2000. The lancet oncology, 2001, 2(9): 533-543.
3. Villaflor VM, Allaic ME, Minsky B, et al. Multidisciplinary approach for patients with esophageal cancer. WJG, 2012, 18(46): 6737.
4. 王文憑, 陳龍奇. 食管癌外科治療的現狀與展望. 中國胸心血管外科臨床雜志, 2011, 18(1): 58-65.
5. Honda M, Kuriyama A, Noma H, et al. Hand-sewn versus mecha-nical esophagogastric anastomosis after esophagectomy: a systematic review and meta-analysis. Ann Surg, 2013, 257(2): 238-248.
6. Godoy MC, Bruzzi JF, Viswanathan C, et al. Multimodality imaging evaluation of esophageal cancer: staging, therapy assessment, and complications. Abdominal Imaging, 2013, 38(5): 974-993.
7. Zhou D, Liu QX, Deng XF, et al. Comparison of two different mechanical esophagogastric anastomosis in esophageal cancer patients: a meta-analysis. J Cardiothorac Surg, 2015, 10(1): 67.
8. 張雪飛, 史小男, 韓彪. 機械與手工食管胃吻合術后吻合口瘺發生率比較的系統評價. 中國循證醫學雜志, 2012, 12(11): 1367-1371.
9. 楊列, 鄭軼峰, 姜建青, 等. 不同食管胃吻合方式對術后并發癥影響的Meta分析. 循證醫學, 2013, 13(3): 173-180.
10. Raz DJ, Tedesco P, Herbella FA, et al. Side-to-side stapled intra-thoracic esophagogastric anastomosis reduces the incidence of leaks and stenosis. Dis Esophagus, 2008, 21(1): 69-72.
11. Deng XF, Liu QX, Zhou D, et al. Hand-sewn vs linearly stapled esophagogastric anastomosis for esophageal cancer: A meta-analysis. WJG, 2015, 21(15): 4757-4764.
12. Higgins J. Green S. Cochrane handbook for systematic reviews of interventions version 5.1. 0. The Cochrane Collaboration, 2011, 5(10):125-239.
13. 武玉兵, 張京楠, 孫毅, 等. 食管胃頸部側側全機械性吻合法在食管癌切除中的臨床應用研究. 中國醫藥指南, 2015, (7): 112-112, 113.
14. 余勇, 胡振東,張勤,等. 食管胃胸腔內側側吻合的臨床效果. 江蘇醫藥, 2015, 41(5): 2.
15. 馬忠廈, 徐有望, 代傳宙, 等. 全機械性食管胃頸部側側吻合在食管癌切除術中的應用. 延邊醫學, 2014, (21): 37-38.
16. 胡風標, 鄒志強, 袁耒, 等. 半機械側吻合和手工吻合兩種食管胃頸部吻合術式的療效比較. 中國現代藥物應用, 2013, (14):115-117.
17. Wang WP, Gao Q, Wang KN, et al. A prospective randomized controlled trial of semi-mechanical versus hand-sewn or circular stapled esophagogastrostomy for prevention of anastomotic stric-ture. World J Surg, 2013, 37(5): 1043-1050.
18. 楊列, 鄭軼峰, 姜建青, 等. 食管癌切除術后頸部食管胃側側吻合與手工端側吻合效果的對照研究. 重慶醫學, 2012, 41(30): 3155-3156,3159.
19. Saluja SS, Ray S, Pal S, et al. Randomized trial comparing side-to-side stapled and hand-sewn esophagogastric anastomosis in neck. J Gastrointest Surg, 2012, 16(7): 1287-1295.
20. Egberts JH, Schniewind B, Bestmann B, et al. Impact of the site of anastomosis after oncologic esophagectomy on quality of life-a prospective, longitudinal outcome study. Ann Surg Oncol, 2008, 15(2): 566-575.
21. Lerut T, Coosemans W, Decker G, et al. Anastomotic complications after esophagectomy. Digest Surg, 2002, 19(2): 92-98.
22. Akiyama H. Chief editor. Surgery for cancer of the esophagus. Hiroshi Akiyama: Williams & Wilkins; 1990.
23. 龍夢云, 韋詩友, 黃芊, 等. 兩種食管上提徑路對食管癌患者術后并發癥影響的系統評價和Meta分析. 中國胸心血管外科臨床雜志, 2015, 22(2): 91-99.
24. 高旭輝, 劉雷霆, 朱水波, 等食管癌患者食管-管狀胃環形吻合器端側吻合與半器械側側吻合近期治療效果觀察. 臨床外科雜志, 2015, (4): 305-307.
25. Aly A, Jamieson GG, Watson DI, et al. An antireflux anastomosis following esophagectomy: a randomized controlled trial. J Gastroin-test Surg, 2010, 14(3): 470-475.
26. Lee J, Anggiansah A, Anggiansah R, et al. Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. Clin Gastroenterology Hepatology, 2007, 5(12): 1392-1398.
27. Paterson WG. The normal antireflux mechanism. Chest surgery clinics of North America, 2001, 11(3): 473-483.
28. Cooke DT, Lin GC, Lau CL, et al. Analysis of cervical esophagogas-tric anastomotic leaks after transhiatal esophagectomy: risk factors, presentation, and detection. Ann Thorac Surg, 2009, 88(1): 177-185.
29. Aly A, Jamieson G, Pyragius M, et al. Antireflux anastomosis following oesophagectomy. ANZ J Surg, 2004, 74(6): 434-438.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Complications in Patients after Side-to-side Esophagogastric Anastomosis: A Systematic Review and Meta-analysis

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