Background Esophageal 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.

Methods We 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 plans We plan to distribute our results in peer-reviewed journal.

The authors have declared no competing interest.

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Yes

https://tm-centre.org.

bioanalitikaaok.pte.hu.

infoszkk.pte.hu.

E-mail addresses of authors: Armand Csontos: csontos.armandgmail.com

Dávid Németh: davidsum96gmail.com

Lajos Szakó M.D.: szaklajgmail.com

Gergő Berke M.D.: berkeg14gmail.com

Dóra Lili Sindler M.D.: lilisindlergmail.com

Prof. Péter Hegyi M.D., Ph.D.: hegyi2009gmail.com

András Papp M.D., Ph.D.: papp.andraspte.hu

All data produced in the present study are available upon reasonable request to the authors