目的:评估食管癌切除术后食管胃经胸骨后或食管床2种重建途径吻合对患者术后的影响。方法:计算机检索Cocharane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库和中文科技期刊全文数据库,检索时间从各数据库建库至2012-12;同时辅助其他检索,纳入食管癌切除术后食管胃经胸骨后或食管床2种重建途径吻合的随机对照试验(randomized controlled trial,RCT)。由2名评价者独立评价纳入研究的质量并提取资料,用RevMan 5.0软件进行统计分析。结果:共纳入11篇RCT,中文3篇,英文8篇,共998例患者。Meta分析结果显示,与胸骨后重建途径比较,食管床途径能明显减少食管胃吻合口瘘发生率(OR=0.52,95%CI:0.33~0.82,P=0.005)和吻合口狭窄的发生率(OR=0.40,95%CI:0.25~0.66,P<0.001),心、肺并发症和住院死亡率差异无统计学意义,其OR值(95%CI)分别为0.50(0.24~1.04)、0.98(0.58~1.65)和0.97(0.27~3.39),P值分别为0.06、0.93和0.96。结论:食管癌切除术后食管胃经食管床途径较胸骨后途径能明显减少吻合口瘘和吻合口狭窄的发生率,使患者受益。 OBJECTIVE: To evaluate the effect of two kinds of reconstructions of esophageal and retroperitoneal esophageal or esophageal reconstruction after esophageal cancer resection. Methods: The databases of Cocharane Library, PubMed, EMBASE, Chinese Biomedical Literature Database, Chinese Journal Full-text Database and Chinese Science and Technology Journals were searched by computer. The retrieval time was from 2012-2012 to the database construction. Meanwhile, other researches were included in esophageal resection Post-esophagogastric retrosternal or esophageal reconstruction of two ways of randomized controlled trial (randomized controlled trial, RCT). Two reviewers independently assessed the quality of the included studies and extracted the data for statistical analysis using RevMan 5.0 software. Results: A total of 11 RCTs, 3 Chinese and 8 English, 998 patients were enrolled. Meta-analysis showed that the esophageal bed route significantly reduced the incidence of esophagogastric fistula (OR 0.52, 95% CI: 0.33-0.82, P = 0.005) and anastomotic stenosis (P < OR = 0.40, 95% CI: 0.25-0.66, P <0.001). There was no significant difference in heart, lung complication and in-hospital mortality between the two groups. The odds ratios (95% CI) were 0.50 (0.24-1.04) (0.58-1.65) and 0.97 (0.27-3.39), P values ​​were 0.06, 0.93 and 0.96, respectively. Conclusion: Esophageal and gastric esophageal approach after esophageal cancer resection can significantly reduce the incidence of anastomotic fistula and anastomotic stenosis, which benefit the patients.