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

IF 1.6 4区医学 Q2 SURGERY Videosurgery and Other Miniinvasive Techniques Pub Date : 2024-04-09 DOI:10.5114/wiitm.2024.138732

Linhai Meng, Chen Zhuming, Huaiwen Xu, Chaohui Wang, Shuangjiu Hu, Zhe Kai

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Abstract

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.

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直肠冲洗对局部复发的影响：一项荟萃分析和系统综述

材料与方法使用 PubMed、Cochrane Library 和 MEDLINE 数据库，对 2005 年 1 月至 2023 年 7 月的直肠癌随机对照试验 (RCT) 和非随机对照试验 (NRCT) 进行了前瞻性研究，对比了直肠冲洗 (RW) 和非直肠冲洗 (NRW) 的效果。结果在涉及 8 项研究的 19855 例患者（15127 例 RW，4728 例 NRW）的分析中，RW 可显著减少局部复发（OR = 0.48）、术中 RW（OR = 0.65）、根治性切除边缘（OR = 1.89）和新辅助治疗（OR = 0.99）（所有 p 均为 0.05）。结论直肠冲洗与预后改善相关，而非冲洗患者从新辅助治疗中获益更多。值得注意的是，不进行新辅助治疗的直肠冲洗仍然有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Videosurgery and Other Miniinvasive Techniques 医学-外科

CiteScore

2.80

自引率

23.50%

发文量

审稿时长

12 weeks

期刊介绍： Videosurgery and other miniinvasive techniques serves as a forum for exchange of multidisciplinary experiences in fields such as: surgery, gynaecology, urology, gastroenterology, neurosurgery, ENT surgery, cardiac surgery, anaesthesiology and radiology, as well as other branches of medicine dealing with miniinvasive techniques.