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Table 2 Intervention characteristics of the included studies

From: Interventions to prevent anastomotic leak after esophageal surgery: a systematic review and meta-analysis

First author (year)

Intervention and control groups

Surgical approach to intervention

Length of stay, days

Diagnostic modality for anastomosis

Medical management

Endoscopic management

Surgical management

Bhat 2006 [6]

Omentoplasty (I) vs hand-sewn anastomosis alone (C)

Cervical: 102

Thoracic: 92

NP

Water-soluble contrast

Abx, bronchodilators, chest physiotherapy

Re-insertion NG tube

Re-exploration, refashioning anastomosis

Dai 2011 [5]

Omentoplasty (I) vs stapled anastomosis alone (C)

Cervical: 75

Thoracic: 180

I: 20.4 (11.5)**

C: 23.1 (15.2)**

Contrast

NP

NP

NP

Daryaei 2008 [19]

NG tube (I) vs Metoclopramide (C)

Cervical: 20

Thoracic: 20

I: 10.9 (3.5**

C: 13.9 (8.2)**

Gastrografin contrast

Metoclopramide (C)

NP

NP

Gupta 2001a [20]

Subtotal (I) vs slender anastomosis (C)

Cervical only

I: 10.7 (3.6)**

C: 11.9 (5.6)**

Water-soluble contrast

Not reported

NP

NP

Hayashi 2019a [21]

Early NG tube removal or no NG tube (I) vs prolonged NG tube removal (C)

Thoracic only

I: 25.7 (12.76)**

C: 29.4 (18.06)**

Contrast agent

All patients received PPI, ICU admission postop

Re-insertion of NG tube

Tracheostomy, mini-tracheostomy

Law 1997 [22]

Stapler (I) vs hand sewn anastomosis (C)

Thoracic only

NP

Gastrografin contrast, endoscopy

NP

NP

NP

Liu 2014 [7]

Valvuloplasty (I) vs stapled anastomosis alone (C)

Cervical: 126

Thoracic: 259

I: 20.4 (11.5)**

C: 22.1 (15.2)**

Contrast, endoscopy

NP

NP

NP

Liu 2015 [23]

Stapler (I) vs hand sewn anastomosis (C)

Cervical: 113

Thoracic: 354

I: 20.1 (6.8)**

C: 18.9 (7.3)**

Barium swallow, endoscopy

Nutrition, chest tube drain

NP

NP

Luechakiettisak 2008 [24]

Stapler (I) vs hand sewn anastomosis (C)

Thoracic only

NP

Gastrografin contrast

NP

NP

NP

Mistry 2012 [25]

Short-term (I) vs prolonged NG tube (C)

Cervical: 33

Thoracic: 117

I: 12 (9 – 17)*

C: 12 (10 – 17)*

Contrast

NP

NP

NP

Nederlof 2011a [26]

End-to-end (I) vs side-to-end (C) anastomosis

Cervical: 88

Thoracic: 40

I: 15 (9 – 125)*

C: 22 (8 – 281)*

Contrast, endoscopy, neck wound saliva

NP

NP

Re-operation

Okuyama 2007 [27]

Stapler (I) vs hand sewn anastomosis (C)

Cervical: 18

Thoracic: 14

NP

Water-soluble contrast

Conservative

NP

NP

Saluja 2012 [28]

Stapler (I) vs hand sewn anastomosis (C)

Cervical only

I: 12.8 (8)**

C: 11.9 (6)**

Gastrografin contrast

Abx, opening neck wound

NP

NP

Zhang 2010 [29]

Stapler (I) vs hand sewn anastomosis (C)

Thoracic only

NP

Chest tube output, contrast barium, endoscopy

Nutrition, chest tube drain

NP

NP

Zheng 2013 [4]

Omentoplasty (I) vs hand-sewn anastomosis (C)

Thoracic only

I: 21 (5)**

C: 23 (6)**

Gastrografin contrast

NP

NP

NP

Tabira 2004 [30]

Subtotal (I) vs slender gastric tube (C)

Thoracic only

NP

NP

Conservative

NP

NP

Valverde 1996a [31]

Stapler (I) vs hand sewn anastomosis (C)

Cervical: 45

Thoracic: 107

NP

Swallow, methylene blue, interstitial fluid in drains

NP

NP

NP

  1. Abx antibiotics, C control, I intervention, mo months, NP not provided, POD postoperative day, TE transesophageal, TH transhiatal, TT transthoracic, wk weeks, Y years
  2. *Median (IQR)
  3. **Mean (SD)
  4. aExcluded from meta-analysis (Valverde 1996, Group results influenced by multiple additional interventions; Nederlof 2011, only study to report intervention type; Hayashi 2019, excluded from AL pooled results because of restriction to reporting grade 3+ AL only; Gupta 2001, only study to report intervention type)