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Siewert II esophagogastric junction adenocarcinoma: Still searching for the right treatment transabdominal or transthoracic surgical approaches?
- Source :
-
Asian cardiovascular & thoracic annals [Asian Cardiovasc Thorac Ann] 2024 May; Vol. 32 (4), pp. 244-255. Date of Electronic Publication: 2024 Mar 28. - Publication Year :
- 2024
-
Abstract
- Introduction: To date, the discussion is still ongoing whether the Siewert II adenocarcinoma of the esophagogastric junction (AEG) should be resected either by thoracoabdominal esophagectomy or gastrectomy with resection of the distal esophagus by transhiatal extension. The aim of our study was to compare the oncological and perioperative outcomes of the transthoracic approach (TTA) and the transabdominal approach (TAA).<br />Methods: Searches of electronic databases identifying studies from Cochrane, PubMed and Google Scholar were performed. Randomised and non-randomised studies comparing TTA and TAA approaches for surgical treatment of AEG Siewert type II were included. The Newcastle-Ottawa and Jada scales were used to evaluate methodological quality. The risk of bias was assessed using the Rob v2 and Robins-I tools. Meta-analyses were conducted for the outcomes.<br />Results: We included 17 trials (2 randomised controlled trials and 15 cohorts) involving 15297 patients. Longer three-year overall survival, five-year overall survival and R0 resection rates were observed in the TTA group. However, TTA had greater morbidity and pulmonary complications.<br />Conclusion: Transthoracic approach appears to be preferable for selected Siewert II tumours. This may lead to higher survival rates and better R0 resection rate. Well-designed studies are needed to confirm the results of this systematic review.<br />Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Subjects :
- Humans
Treatment Outcome
Risk Factors
Time Factors
Male
Female
Middle Aged
Postoperative Complications etiology
Aged
Patient Selection
Esophagogastric Junction surgery
Esophagogastric Junction pathology
Adenocarcinoma surgery
Adenocarcinoma mortality
Adenocarcinoma pathology
Esophageal Neoplasms surgery
Esophageal Neoplasms mortality
Esophageal Neoplasms pathology
Esophagectomy adverse effects
Esophagectomy mortality
Gastrectomy mortality
Gastrectomy adverse effects
Stomach Neoplasms surgery
Stomach Neoplasms mortality
Stomach Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1816-5370
- Volume :
- 32
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Asian cardiovascular & thoracic annals
- Publication Type :
- Academic Journal
- Accession number :
- 38545667
- Full Text :
- https://doi.org/10.1177/02184923241238486