[A meta-analysis of esophagectomy: the comparative study of Ivor-Lewis operation and Sweet operation]

Investigate the best surgical resection of esophageal cancer by comparing the efficacy and safety between Ivor-Lewis esophagectomy and Sweet esophagectomy.

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. RevMan 5.2 software was used for data analysis.

A total of 4106 patients in 15 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 hospital stay, 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=0.52).

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.