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Background  Esophageal cancer has a poor prognosis. Surgery is the main treatment but involves a high risk of complications. Some surgical strategies have tried to eliminate complications. Our meta-analysis tried to find the benefits of single-lumen endotracheal tube intubation with carbon dioxide (CO 2 ) inflation.    Methods  A systematic search of studies on esophagectomy and CO 2  inflation was conducted using PubMed, Medline, and Scopus. The odds ratio of post-operative pulmonary complications and anastomosis leakage were the primary outcomes. The standardized mean difference (SMD) in post-operative hospitalization duration was the secondary outcome.    Results  The meta-analysis included four case-control studies with a total of 1503 patients. The analysis showed a lower odds ratio of pulmonary complications in the single-lumen endotracheal tube intubation in the CO 2  inflation group (odds ratio: 0.756 [95% confidence interval, CI: 0.518 to 1.103]) compared to that in the double-lumen endotracheal tube intubation group, but anastomosis leakage did not improve (odds ratio: 1.056 [95% CI: 0.769 to 1.45])). The SMD in hospitalization duration did not show significant improvement. (SMD: -0.141[95% CI: − 0.248 to − 0.034]).    Conclusions  Single-lumen endotracheal tube intubation with CO 2  inflation improved pulmonary complications and shortened the hospitalization duration. However, no benefit in anastomosis leakage was observed.

journal of cardiothoracic surgery

Improvement of surgical complications using single-lumen endotracheal tube intubation and artificial carbon dioxide pneumothorax in esophagectomy: a meta-analysis