The necessity of pyloric drainage in esophagectomies: protocol of a meta-analysis and a systematic review of randomized controlled trials.

BackgroundEsophageal carcinoma is the 8th most common malignant tumour in the world with more than 600 000 cases (3.1% of all), while being the 6th most common reason of tumour mortality, causing more than 500 000 deaths (5.5% of all) annually. The 1, 3 and 5 year-prevalence are 2.4%, 1.6% and 1.3% respectively. The question of this meta-analysis is whether pyloric drainage is preferable over the lack of pyloric drainage during elective esophagectomies in patients suffering from esophageal cancer, regarding mortality, anastomosis leakage, respiratory morbidity, vomiting, gastric emptying time. MethodsWe plan to identify randomized controlled trials to investigate the question by performing extensive search in multiple databases. Based on of predefined criteria, two independent authors will perform the steps of selection, after which appropriate statistical analysis will be performed to identify potential significant differences. Cochrane Risk of Bias Tool 2, and GRADE approach will be used to estimate the risk of bias and quality of results. Dissemination plansWe plan to distribute our results in peer-reviewed journal.