SynthesisWorld journal of surgery2026
Comparing Minimally-Invasive and Open Approaches to Siewert II/III Gastro-Esophageal Junction Adenocarcinoma-A Systematic Review and Network Meta-Analysis.
Synthesis in World journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe prevalence of adenocarcinoma of the esophagogastric junction has increased, likely driven by lifestyle factors such as obesity, gastro-esophageal reflux disease, and smoking. However, the long-term outcomes of different curative surgical approaches have yet to be comprehensively evaluated.
objectivesTo perform a systematic review and meta-analysis evaluating the surgical approaches to resection of Siewert II/III Adenocarcinoma of the Esophagogastric junction.
settingIntegration of data from upper gastrointestinal surgical units across the world.
methodsA systematic review was performed as per PRISMA guidelines. Statistical analysis was performed with MetaInsight.
resultsA total of 16 studies, comprising 4256 patients, were included in the meta-analysis. The findings suggest that robotic surgical approaches demonstrate equipoise to both laparoscopic and open techniques for resection, with comparable overall survival (OS) at both 3 and 5 years (3-year OS: OR 1.17, 95% CI [0.10-14.06]; 5-year OS: OR 0.66, 95% CI [0.39-1.12]). Additionally, a nonsignificant trend toward improved disease-free survival (DFS) was observed for robotic surgery at both 3 and 5 years (OR 1.17, 95% CI [0.10-14.06] for both time points).
conclusionLaparoscopic approaches to surgical resection have proven to be as effective as open surgery for achieving R0 resection. Based on our meta-analysis results, we can conclude that robotic approaches to resection is equivalent to laparoscopic approaches. PROSPECTIVE REGISTER: International Prospective Register of Systematic Reviews (PROSPERO): CRD42024590940.
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