Summary of findings 2. Laparoscopic versus open transhiatal oesophagectomy for oesophageal cancer: secondary 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 recurrence (within 6 months) | 1 per 1000 | 1 per 1000 (0 to 18) | RR 0.88 (0.04 to 18.47) | 20 (1 study) | ⊕⊝⊝⊝ very low1,2,3 |
|
Long‐term recurrence Follow‐up: 10 months |
241 per 1000 | 241 per 1000 (207 to 278) | HR 1 (0.84 to 1.18) | 173 (2 studies) | ⊕⊝⊝⊝ very low1,3 |
| Adverse events (proportion) | 623 per 1000 | 399 per 1000 (299 to 536) | RR 0.64 (0.48 to 0.86) | 213 (3 studies) | ⊕⊝⊝⊝ very low1,3 |
| Blood transfusion (proportion) | 162 per 1000 | 13 per 1000 (0 to 219) | RR 0.08 (0 to 1.35) | 73 (1 study) | ⊕⊝⊝⊝ very low1,2,3 |
| Blood transfusion (quantity) | The median blood transfused was 2.5 units | The median blood transfused was 2.5units less (confidence intervals ‐ not available; statistical significance ‐ not known) | 93 (1 study) | ⊕⊝⊝⊝ very low1,3 | |
| Length of hospital stay | The median hospital stay rangedbetween 11 and 16 days | The median hospital stay was 3 days less (confidence intervals ‐ not available; statistically significant) | 266 (3 studies) | ⊕⊝⊝⊝ very low1,3 | |
| Positive resection margins | 243 per 1000 | 158 per 1000 (90 to 272) | RR 0.65 (0.37 to 1.12) | 213 (3 studies) | ⊕⊝⊝⊝ very low1,2,3 |
| Number of harvested lymph nodes | The median number of lymph nodes harvested ranged between 11 and 36 | The median number of lymph nodes was 12 fewer to 3 more (confidence intervals ‐ not available; not statistically significant or statistical significance ‐ not known) | 326 (5 studies) | ⊕⊝⊝⊝ very low1,3,4 | |
| None of the studies reported time‐to‐return to normal activity (return to pre‐operative mobility without additional caregiver support), or time‐to‐return to work. | |||||
| *The basis for the assumed risk is the mean control group proportion except for short‐term recurrence where a control group proportion of 0.1% was used since there was no recurrence in the control group. 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.
4 The results were inconsistent across studies.