Abstract Background Minimally invasive oesophagectomy (MIO) for oesophageal cancer may reduce surgical complications compared with open oesophagectomy. MIO is, however, technically challenging and may impair optimal oncological resection. The aim of the present study was to assess if MIO for cancer is beneficial. Methods A systematic literature search in MEDLINE, Web of Science and CENTRAL was performed and randomized controlled trials (RCTs) comparing MIO with open oesophagectomy were included in a meta-analysis. Survival was analysed using individual patient data. Random-effects model was used for pooled estimates of perioperative effects. Results Among 3219 articles, six RCTs were identified including 822 patients. Three-year overall survival (56 (95 per cent c.i. 49 to 62) per cent for MIO versus 52 (95 per cent c.i. 44 to 60) per cent for open; P = 0.54) and disease-free survival (54 (95 per cent c.i. 47 to 61) per cent versus 50 (95 per cent c.i. 42 to 58) per cent; P = 0.38) were comparable. Overall complication rate was lower for MIO (odds ratio 0.33 (95 per cent c.i. 0.20 to 0.53); P < 0.010) mainly due to fewer pulmonary complications (OR 0.44 (95 per cent c.i. 0.27 to 0.72); P < 0.010), including pneumonia (OR 0.41 (95 per cent c.i. 0.22 to 0.77); P < 0.010). Conclusion MIO for cancer is associated with a lower risk of postoperative complications compared with open resection. Overall and disease-free survival are comparable for the two techniques.

中文翻译：

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比较微创与开放食管切除术治疗癌症的随机对照试验和个体患者数据的荟萃分析

摘要 背景与开放食管切除术相比，微创食管切除术（MIO）治疗食管癌可以减少手术并发症。然而，MIO 在技术上具有挑战性，并且可能会损害最佳的肿瘤切除。本研究的目的是评估 MIO 对癌症是否有益。 方法在 MEDLINE、Web of Science 和 CENTRAL 中进行了系统文献检索，并将比较 MIO 与开放食管切除术的随机对照试验 (RCT) 纳入荟萃分析。使用个体患者数据分析生存率。随机效应模型用于围手术期效应的汇总估计。 结果在 3219 篇文章中，确定了 6 项随机对照试验，涉及 822 名患者。三年总生存率（MIO 为 56（95% CI 49 至 62）%，而开放手术为 52（95% CI 44 至 60）%；P = 0.54）和无病生存率（54（95% CI 44 至 60）） % CI 47 至 61)% 与 50% (95% CI 42 至 58)%；P = 0.38) 具有可比性。MIO 的总体并发症发生率较低（比值比 0.33（95% CI 0.20 至 0.53）；P < 0.010），主要是由于肺部并发症较少（OR 0.44（95% CI 0.27 至 0.72）；P < 0.010） ，包括肺炎（OR 0.41（95% CI 0.22 至 0.77）；P < 0.010）。 结论与开放切除术相比，MIO 治疗癌症术后并发症的风险较低。两种技术的总体生存率和无病生存率相当。