Summary of findings for the main comparison. Laparoscopic versus open transhiatal oesophagectomy for oesophageal cancer: primary outcomes.
| Laparoscopic versus open transhiatal oesophagectomy for oesophageal cancer | |||||
|
Patient or population: patients with oesophageal cancer
Settings: upper gastrointestinal surgery unit
Intervention: laparoscopic transhiatal oesophagectomy Control: open transhiatal oesophagectomy | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Open transhiatal oesophagectomy | Laparoscopic transhiatal oesophagectomy | ||||
|
Short‐term mortality (in hospital or within 3 months) |
11 per 1000 | 5 per 1000 (1 to 47) | RR 0.44 (0.05 to 4.09) | 326 (5 studies) | ⊕⊝⊝⊝ very low1,2,3 |
| Long‐term mortality Follow‐up: median 2 years | 355 per 1000 | 346 per 1000 (299 to 398) | HR 0.97 (0.81 to 1.16) | 193 (2 studies) | ⊕⊝⊝⊝ very low1,3 |
| Serious adverse events (proportion) | 211 per 1000 | 103 per 1000 (51 to 208) | RR 0.49 (0.24 to 0.99) | 213 (3 studies) | ⊕⊝⊝⊝ very low1,3 |
| Anastomotic stenosis | 81 per 1000 | 111 per 1000 (27 to 462) | RR 1.37 (0.33 to 5.7) | 73 (1 study) | ⊕⊝⊝⊝ very low1,2,3 |
| None of the studies reported post‐operative dysphagia or health‐related quality of life. | |||||
| *The basis for the assumed risk was the mean control group proportion. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; HR: Hazard ratio. | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
1 Risk of bias was unclear or high in the study/studies. 2 The confidence intervals were wide (overlapped clinically significant effects and no effect). 3 The sample size was small.