Transthoracic versus abdominal-transhiatal resection for treating Siewert type II/III XXXX : a meta-analysis.

@entity1 @entity834 @entity353 @entity190 @entity420 @entity65
Our study aimed to explore the differences in short and long-term outcomes about the transthoracic (TH) and abdominal-transhiatal (TH) approaches for treating esophagogastric junction (AEG). A systematic review of PubMed, EMbase, Cochrane Library, China National Knowledge Infrastructure and CBMdisc was performed. All original articles comparing TH with TA were included in the study. Meta-analysis was conducted using odd ratios (OR) and @entity353 ( @entity353 ).Thirteen studies including 2489 @entity1 with @entity420 , with 1050 @entity1 underwent TA and 1437 @entity1 underwent TH were pooled for this study. There were no significant difference between two approaches concerning duration of operation, @entity190 , @entity834 and positive of proximal incisal margin. Lymph node excised also showed no significant differences between two procedures in RCTs while in TA group of Non-RCTs, the number of lymph node dissection is higher. TH approach was associated with a longer length of hospital stay and had higher incidence of @entity65 and early postoperative mortality. Overall analysis of 1, 3, 5-year survival showed no significant difference between two approaches. Based on the study, TA approach had a positive impact than TH for AEG with respect to @entity65 , hospital stay and early mortality rates. There were no significant differences between the two approaches for long-term survival. Therefore, two surgical approaches are acceptable, and the elders with poor cardiopulmonary function, we recommended TA approach for treating it.
