Minimal access oesophagectomy Systematic review and sub group meta analyses based on Randomised Controlled trials
Background All studies conducted to compare minimal access oesophagectomy MAO with open oesophagectomy OO till date, have the limitation that they are primarily bas ed on non randomized studies. Only evidence based on randomised controlled trials RC Ts can establish MAO as the preferred surgery for resectable oesophageal cancer OCA and hence the current review. Objectives This review aims to establish a firm body of evidence in support of MAO. The objectives involve using PICO strategy and searching for relevant RCTs, extracting and analyzing data from them in order to derive conclusions that help establish evidence in favour of MAO. Data Sources of the current review are RCTs that asess outcomes of MAO. Review methodology Quantitave study has been designed through a systematic review and meta analyses of RCTs. Results Blood loss during surgery, post operative pulmonary infection and duration of hospital stay favour MAO versus OO for resectable OCA management. Conclusion The ideal MAO strategy may involve thoracoscopic oesophagectomy in prone position with low tidal volume ventilation, perioperative administration of amino acids and neutrophil elastase inhibitor plus immediate postoperative chest physiotherapy and enteral feeding.
Minimal access oesophagectomy, Minimally invasive esophagectomy, Thoracoscopic oesophagectomy, Laparoscopic oesophagectomy, Laparoscopy, Oesophageal carcinoma
Dr. Syed SumairaNawaz