WITHDRAWN: Intrathoracic versus cervical anastomosis in esophagectomy for esophageal cancer: A meta-analysis of randomized controlled trials

Abstract

<h2>Abstract</h2><h3>Background</h3> Intrathoracic anastomosis(IA) and cervical anastomosis(CA) has been used for the esophagectomy of esophageal cancer, we aimed to evaluate the effects and safety of IA versus CA in the esophagectomy. <h3>Methods</h3> We searched PubMed, EMBASE, The Cochrane Library, Web of Knowledge, China national knowledge infrastructure (CNKI) and WanFang databases up to Sept 30, 2021 for RCTs on CA versus IA for the treatment of esophageal cancer. <h3>Results</h3> 12 RCTs total of 1493 patients were finally included. hThe incidence of anastomotic leak[RR = 2.76, 95%CI (1.94–3.94), P < 0.001] and recurrent laryngeal nerve injury [RR = 6.12, 95%CI (3.02–12.41), P < 0.001] in the IA group were less than that of CA group. There were no significant difference in the incidence of anastomotic stenosis [RR = 1.33, 95%CI (0.88–2.00), P = 0.18], pneumonia [RR = 1.31, 95%CI (0.82–2.09), P = 0.25], postoperative chylothorax[RR = 1.01, 95%CI (0.40–2.52), P = 0.99] and mortality [RR = 0.93, 95%CI (0.52–1.68), P = 0.82] between two groups. <h3>Conclusions</h3> IA is a safer and more reliable method of gastrointestinal reconstruction for esophagectomy.