Transhiatal versus transthoracic esophagectomy for esophageal cancer

Table 1 Meta-analysis comparing transthoracic and transhiatal esophagectomy

Meta-analysis	Rindani et al[20]	Hulscher et al[21]
No. of patients	5483	7527
Postoperative mortality (%)
TT	9.5	9.2
TH	6.3	5.7
Intraoperative blood loss (mL)
TT	1171	1001
TH	1311	728
Hospital stay (d)
TT	19.8	21
TH	19.5	17.8
Pulmonary complications (%)
TT	25	18.7
TH	24	12.7
Cardiac complications (%)
TT	10.5	6.6
TH	12.4	19.5
Anastomotic leakage (%)
TT	10	7.2
TH	16	13.6
Vocal cord paralysis (%)
TT	4.8	3.5
TH	11.2	9.5
5-yr OS (%)
TT	26	23
TH	24	21.7

TT: Transthoracic esophagectomy; TH: Transhiatal esophagectomy; OS: Overall survival.

Table 2 Randomized trials comparing transthoracic and transhiatal esophagectomy

Meta-analysis	Goldminc et al[27]	Chu et al[28]	Jacobi et al[29]	Hulscher et al[30,31]
No. of patients	67	39	32	220
Postoperative mortality (%)
TT	8.6	0	6	4
TH	6.2	0	6	2
Intraoperative blood loss (mL)
TT	1(2.3 units transfused)	671	2270	1900
TH	1(2.3 units transfused)	724	1000	1000
Hospital stay (d)
TT	18	27	21	19
TH	20.5	18	23	15
Postoperative pneumonia (%)
TT	20	0	31	57 (atelectasis included)
TH	19	10	19	27 (atelectasis included)
Cardiac complications (%)
TT	1	15.8	19	26
TH	1	15	31	16
Anastomotic leakage (%)
TT	9	0	12.5	16 (subclinical included)
TH	6	0	12.5	14 (subclinical included)
Vocal cord paralysis (%)
TT	3	1	1	21 (transient)
TH	3	1	1	13 (transient)
Reported survival (%)
TT	22 at 3 yr	Median survival 13.5 mo	77 at 1 yr	36 at 5 yr
TH	30 at 3 yr	Median survival 16 mo	70 at 1 yr	34 at 5 yr

¹Data not reported or did not occur. TT: Transthoracic esophagectomy; TH: Transhiatal esophagectomy.