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目的:通过系统评价和Meta分析，评价胸腔镜手术与传统开胸手术治疗先天性食管闭锁的临床疗效及安全性。方法:检索维普数据库、万方数据库、中国知网、中国生物医学文献数据库、PubMed数据库、Embase数据库、Cochrane图书馆中收录的胸腔镜手术与传统开胸手术治疗先天性食管闭锁的随机或非随机对照试验、队列研究和病例对照研究。结局指标包括术后并发症(吻合口漏、食管狭窄、复发性气管食管瘘、胃底折叠术、术后肌肉骨骼畸形、肺部并发症、伤口感染、膈神经麻痹、声带麻痹、死亡)、手术时间、失血量、拔管时间、住院时间和术后第一次经口喂养时间。采用漏斗图，Egger\'s及Begg\'s检验分析纳入研究的发表偏倚，使用RevMan 5.3软件进行数据分析。结果:最终纳入25项研究的1 552例患儿进行Meta分析，将698例接受胸腔镜手术的患儿作为胸腔镜手术组，将854例接受传统开胸手术的患儿作为传统开胸手术组。数据分析结果显示，胸腔镜手术组的手术时间较传统开胸手术组长[n MD＝22.61，95%n CI(10.93，34.29)]，两组间的差异具有统计学意义。胸腔镜手术组与传统开胸手术组相比，术后的并发症发生率[n OR＝1.06，95%n CI(0.62，1.82)]、吻合口漏发生率[n OR＝1.11，95%n CI(0.59，2.09)]、食管狭窄发生率[n OR＝1.39，95%n CI(0.89，2.18)]、复发性气管食管瘘发生率[n OR＝1.82，95%n CI(0.95，3.47)]、胃底折叠术发生率[n OR＝0.85，95%n CI(0.39，1.87)]、拔管时间[n MD＝-0.18，95%n CI(-0.67，0.32)]和住院时间[n MD＝-2.04，95%n CI(-4.25，0.17)]在两组间的差异无统计学意义。n 结论:现有证据表明，与传统开胸手术相比，胸腔镜手术治疗先天性食管闭锁的手术时间较长，但术后并发症的发生率没有增加。“,”Objective:To review the currently available data and evaluate the efficacy and safety of thoracoscopic repair (TR) versus conventional open repair (COR) for congenital esophageal atresia (CEA) through systematic review and Meta analysis.Methods:The databases of VIP, WanFang, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), PubMed, Embase and Cochrane Library were searched for randomized or non-randomized controlled trials, cohort studies and case-control studies of TR versus COR for the treatment of CEA.The measurement parameters included postoperative complications (including anastomotic leakage, esophageal stenosis, recurrent tracheoesophageal fistula, fundoplication, musculoskeletal deformity, pulmonary complication, wound infection, phrenic nerve paralysis, vocal cord paralysis and mortality), operative duration, volume of blood loss, extubation time, hospitalization stay and initial first oral feeding time post-operation.Meta-analysis was performed with RevMan 5.3 software.Results:A total of 1 552 patients from 25 studies examining the effectiveness of TR (n=698) versus COR (n=854) were included for Meta-analysis.Operative duration was significantly higher in TR group than that in COR group [n MD=22.61, 95%n CI(10.93, 34.29)]. No significant intergroup difference existed in postoperative complication rate [n OR=1.06, 95%n CI(0.62, 1.82)]. Likewise, no statistically significant differences existed in anastomotic leak rate [n OR=1.11, 95%n CI(0.59, 2.09)], esophageal stenosis rate [n OR=1.39, 95%n CI(0.89, 2.18)], recurrent tracheoesophageal fistula rate [n OR=1.82, 95%n CI(0.95, 3.47)] or fundoplication rate [n OR=0.85, 95%n CI(0.39, 1.87)]. Furthermore, extubation time and hospitalization stay of TR group were the same as those of COR group [n MD=-0.18, 95%n CI(-0.67, 0.32)][n MD=-2.04, 95%n CI(-4.25, 0.17)].n Conclusions:Existing evidence shows that, as compared with COR, TR for CEA has a longer operative duration and there is no higher incidence of postoperative complications.