Posição prona como fator de redução de pneumonia na esofagectomia para câncer de esôfago: revisão sistemática e metaanálise

Abstract

BACKGROUND: The esophagectomy is still considered the best treatment to esophageal cancer. There are many complications after esophagectomy like pneumonia, cardiac arytmia, quilothorax and leakage. The thoracoscopy reduces postoperative mortality of esophagectomy due reduction in respiratory complications. This systematic review and meta-analysis aim to study about prone position in minimally invasive esophagectomy in reducing the postoperative pneumonia. OBJECTIVES: General: It was made a systematic review and meta-analysis about the reduction in postoperative respiratory complications in prone position versus lateral decubitus position in minimally invasive esophagectomy to esophageal cancer. Specific: To check if the thoracoscopy in prone position reduces the pneumonia in postoperative esophagectomy to esophageal cancer. METHOD: It was researched papers on database of Embase, Medline, LILACS and Cochrane Library, using the following specific terms “minimally invasive procedure”, “minimally invasive surgery”, “prone”, “esophageal cancer”, “postoperative complication” mixed with AND and OR. Then it selected the articles and extract the data to make a systematic review and meta-analysis. RESULTS: Six retrospective cohort were included in the systematic review. A total of 493 patients undergone to esophagectomy for esophageal cancer, distributed in two arms the prone position (PP) and in the lateral decubitus position (LDP). All patients undergone thoracoscopic esophagectomy. CONCLUTION: The prone position (PP) reduces in 52% postoperative pneumonia rate in minimally invasive esophagectomy for esophageal cancer [RR=0,48; (IC95%: 0,30 – 0,76); p=0,002; I²=0%].