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Selective decontamination of the digestive tract in esophagectomy and the incidence of pneumonia and anastomotic leakage: A systematic review and meta-analysis

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  • Sander Du X Oei
  • Jasper Gerrit Jan Verbruggen
  • Sanne Elisabeth Hoeks
  • Marcus Paulus Buise

Abstract

Background: Despite advances in surgery, esophagectomy remains a major operation in which pneumonia and anastomotic leakage are causes of morbidity. It is currently unknown whether selective decontamination of the digestive tract (SDD) affects the incidence of postoperative pneumonia and anastomotic leakage in patients undergoing esophagectomy. The aim of this systematic review and meta-analysis is to summarize current evidence regarding SDD in patients undergoing esophagectomy. Methods: We performed a comprehensive search in Medline, Web of Science, Embase, Cochrane Library and Google Scholar with articles included until August 2024. We included observational studies and clinical trials which were scored using the Cochrane Risk of Bias tool and The Risk Of Bias In Non-randomized Studies – of Interventions. A fixed effects model was used to pool results of the former studies. Results: A total of five studies were identified with a total of 924 patients. All studies were assessed as either having serious bias or a high risk of bias. SDD usage was associated with a significantly lower incidence of pneumonia (OR 0.41; 95% CI 0.29 to 0.58; p

Suggested Citation

  • Sander Du X Oei & Jasper Gerrit Jan Verbruggen & Sanne Elisabeth Hoeks & Marcus Paulus Buise, 2025. "Selective decontamination of the digestive tract in esophagectomy and the incidence of pneumonia and anastomotic leakage: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 20(6), pages 1-13, June.
    • Handle: RePEc:plo:pone00:0325241
    DOI: 10.1371/journal.pone.0325241
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