Impact of rectal washout in local recurrence: a meta-analysis and systemic review

被引：0

作者：

Meng, Linhai ^{[1
]}

Chen, Zhuming ^{[1
]}

Xu, Huaiwen ^{[1
]}

Wang, Chaohui ^{[1
]}

Hu, Shuangjiu ^{[1
]}

Kai, Zhe ^{[1
]}

机构：

[1] Anhui Med Univ, Anqing Peoples Hosp 1, Dept Gen Surg, Anqing, Peoples R China

来源：

VIDEOSURGERY AND OTHER MINIINVASIVE TECHNIQUES | 2024年 / 19卷 / 02期

关键词：

rectal cancer; rectal washout; local recurrence; quality of life; meta; -analysis; CANCER; RESECTION; SURGERY; MARGIN; IMPLANTATION; INVOLVEMENT; CARCINOMA; EFFICACY; LAVAGE;

D O I：

10.5114/wiitm.2024.138732

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Introduction: Rectal washout is proposed for eliminating free cancer cells, yet evidence on its efficacy in preventing local recurrence after anterior resection is inconclusive. Material and methods: Contrasting rectal washout (RW) and non-rectal washout (NRW) in rectal cancer, a prospective study of randomized control trials (RCT) and non-randomized control trials (NRCT) from January 2005 to July 2023 was conducted using PubMed, Cochrane Library, and MEDLINE databases. Meta-statistical analysis in RevMan 5.4 addressed heterogeneity. Results: In analysis involving 19,855 patients (15127 RW, 4728 NRW) from eight studies, RW significantly reduced local recurrence (OR = 0.48), intraoperative RW (OR = 0.65), radical resection margins (OR = 1.89), and neoadjuvant therapy (OR = 0.99) (all p < 0.05). Subgroup RCT analysis reinforced these findings. Conclusions: Rectal washout correlates with improved outcomes, while non-washout patients benefit more from neoadjuvant therapy. Notably, rectal washout without neoadjuvant remains efficacious.

引用

页码：129 / 140

页数：12

共 37 条

[1] ROLE OF CIRCUMFERENTIAL MARGIN INVOLVEMENT IN THE LOCAL RECURRENCE OF RECTAL-CANCER [J].

ADAM, IJ ;

MOHAMDEE, MO ;

MARTIN, IG ;

SCOTT, N ;

FINAN, PJ ;

JOHNSTON, D ;

DIXON, MF ;

QUIRKE, P .

LANCET, 1994, 344 (8924) :707-711

[2] EXTENT OF MESORECTAL SPREAD AND INVOLVEMENT OF LATERAL RESECTION MARGIN AS PROGNOSTIC FACTORS AFTER SURGERY FOR RECTAL-CANCER [J].

CAWTHORN, SJ ;

PARUMS, DV ;

GIBBS, NM ;

AHERN, RP ;

CAFFAREY, SM ;

BROUGHTON, CIM ;

MARKS, CG .

LANCET, 1990, 335 (8697) :1055-1059

[3] EFFICACY OF TUMORICIDAL AGENTS IN-VITRO AND IN-VIVO [J].

DOCHERTY, JG ;

MCGREGOR, JR ;

PURDIE, CA ;

GALLOWAY, DJ ;

ODWYER, PJ .

BRITISH JOURNAL OF SURGERY, 1995, 82 (08) :1050-1052

[4] Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm III): a multicentre, randomised, non-blinded, phase 3, non-inferiority trial [J].

Erlandsson, Johan ;

Holm, Torbjorn ;

Pettersson, David ;

Berglund, Ake ;

Cedermark, Bjorn ;

Radu, Calin ;

Johansson, Hemming ;

Machado, Mikael ;

Hjern, Fredrik ;

Hallbook, Olof ;

Syk, Ingvar ;

Glimelius, Bengt ;

Martling, Anna .

LANCET ONCOLOGY, 2017, 18 (03) :336-346

[5] Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy [J].

Garcia-Aguilar, Julio ;

Patil, Sujata ;

Gollub, Marc J. ;

Kim, Jin K. ;

Yuval, Jonathan B. ;

Thompson, Hannah M. ;

Verheij, Floris S. ;

Omer, Dana M. ;

Lee, Meghan ;

Dunne, Richard F. ;

Marcet, Jorge ;

Cataldo, Peter ;

Polite, Blase ;

Herzig, Daniel O. ;

Liska, David ;

Oommen, Samuel ;

Friel, Charles M. ;

Ternent, Charles ;

Coveler, Andrew L. ;

Hunt, Steven ;

Gregory, Anita ;

Varma, Madhulika G. ;

Bello, Brian L. ;

Carmichael, Joseph C. ;

Krauss, John ;

Gleisner, Ana ;

Paty, Philip B. ;

Weiser, Martin R. ;

Nash, Garrett M. ;

Pappou, Emmanouil ;

Guillem, Jose G. ;

Temple, Larissa ;

Wei, Iris H. ;

Widmar, Maria ;

Lin, Sabrina ;

Segal, Neil H. ;

Cercek, Andrea ;

Yaeger, Rona ;

Smith, J. Joshua ;

Goodman, Karyn A. ;

Wu, Abraham J. ;

Saltz, Leonard B. .

JOURNAL OF CLINICAL ONCOLOGY, 2022, 40 (23) :2546-+

[6] Optimizing the outcome for patients with rectal cancer [J].

Gibbs, P ;

Chao, MW ;

Tjandra, JJ .

DISEASES OF THE COLON & RECTUM, 2003, 46 (03) :389-402

[7] Prognostic significance of a positive radial margin after esophageal cancer resection [J].

Gilbert, Sebastien ;

Martel, Andre B. ;

Seely, Andrew J. ;

Maziak, Donna E. ;

Shamji, Farid M. ;

Sundaresan, Sudhir R. ;

Villeneuve, P. James .

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2015, 149 (02) :548-555

[8] LOCAL RECURRENCES AFTER SPHINCTER-SAVING EXCISIONS FOR CARCINOMA OF THE RECTUM AND RECTOSIGMOID [J].

GOLIGHER, JC ;

DUKES, CE ;

BUSSEY, HJR .

BRITISH JOURNAL OF SURGERY, 1951, 39 (155) :199-211

[9] Measuring inconsistency in meta-analyses [J].

Higgins, JPT ;

Thompson, SG ;

Deeks, JJ ;

Altman, DG .

BMJ-BRITISH MEDICAL JOURNAL, 2003, 327 (7414) :557-560

[10] Multicenter, Randomized, Phase III Trial of Short-Term Radiotherapy Plus Chemotherapy Versus Long-Term Chemoradiotherapy in Locally Advanced Rectal Cancer (STELLAR) [J].

Jin, Jing ;

Tang, Yuan ;

Hu, Chen ;

Jiang, Li-Ming ;

Jiang, Jun ;

Li, Ning ;

Liu, Wen-Yang ;

Chen, Si-Lin ;

Li, Shuai ;

Lu, Ning-Ning ;

Cai, Yong ;

Li, Yong-Heng ;

Zhu, Yuan ;

Cheng, Guang-Hui ;

Zhang, Hong-Yan ;

Wang, Xin ;

Zhu, Su-Yu ;

Wang, Jun ;

Li, Gao-Feng ;

Yang, Jia-Lin ;

Zhang, Kuan ;

Chi, Yihebali ;

Yang, Lin ;

Zhou, Hai-Tao ;

Zhou, Ai-Ping ;

Zou, Shuang-Mei ;

Fang, Hui ;

Wang, Shu-Lian ;

Zhang, Hai-Zeng ;

Wang, Xi-Shan ;

Wei, Li-Chun ;

Wang, Wen-Ling ;

Liu, Shi-Xin ;

Gao, Yuan-Hong ;

Li, Ye-Xiong .

JOURNAL OF CLINICAL ONCOLOGY, 2022, 40 (15) :1681-+

← 1 2 3 4 →