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. 2016 Mar 31;2016(3):CD011390. doi: 10.1002/14651858.CD011390.pub2

Cash 2014.

Methods Study design: retrospective cohort study
Participants Country: USA.
 Number eligible: 93.
 Number excluded: not stated.
 Number analysed: 93.
 Average age: 74 years.
 Females: 20 (21.5%).
 Stage I: 37(39.8%).
 Stage II: 22 (23.7%).
 Stage III: 34 (36.6%).
 Stage IV: not stated
 Squamous cell carcinoma: not stated
 Adenocarcinoma: not stated
 Study design: Retrospective cohort study with historical control
 Total follow‐up in months: median: 26 months for laparoscopic oesophagectomy group and 64 months for open oesophagectomy group (survival at 24 months was used for calculation of proportion survived)
 ASA: not stated
 Location: not stated
Inclusion criteria
 Patients undergoing transhiatal oesophagectomy for oesophageal cancer
Exclusion criteria
 People who had undergone major abdominal surgery.
Interventions Group 1: laparoscopic transhiatal oesophagectomy (N = 33).
 Further details: number of ports ‐ not stated; minilaparotomy ‐ incision size not stated; drain use ‐ not stated.
 Group 2: open transhiatal oesophagectomy (N = 60).
 Further details: incision size ‐ not stated; drain use ‐ not stated.
Outcomes The outcomes reported were short‐term and long‐term mortality, morbidity, long‐term recurrence, length of hospital stay, and number of lymph nodes harvested.
Notes Proportion of people with cancer: 100%
Conversion: 2/33 (6.1%)
Risk of bias
Bias Authors' judgement Support for judgement
Bias due to confounding High risk Critical risk of bias
Comment: The tumour size was smaller in the laparoscopic group but more patients had neo‐adjuvant therapy in the laparoscopic group.
Bias due to selection of participants to intervention and control Low risk Moderate
Comment: This was a consecutive series of laparoscopic oesophagectomies where the surgeon performed all transhiatal oesophagectomies laparoscopically other than for those who had undergone major abdominal surgery after July 2008
Bias due to differences in co‐interventions which were different between the groups Unclear risk No information
Comment: A historical control was used. It was not clear there were other differences in care of the patient apart from the intervention and control.
Bias in the measurement of outcomes Unclear risk No information
Comment: Information on observer blinding was not available.
Bias due to missing data Unclear risk No information
Comment: This information was not available.
Bias in selection of the reported findings Low risk Low risk of bias
Comment: Mortality and morbidity were reported.