scholarly journals The efficacy of ileostomy after laparoscopic rectal cancer surgery: a meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yu Mu ◽  
Linxian Zhao ◽  
Hongyu He ◽  
Huimin Zhao ◽  
Jiannan Li
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Meta Analysis ◽  
Operation Time ◽  
Postoperative Hospital Stay ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Anastomotic Leakage Rate ◽  
Protective Ileostomy ◽  
Clinically Significant

Abstract Background Protective ileostomy is always applied to avoid clinically significant anastomotic leakage and other postoperative complications for patients receiving laparoscopic rectal cancer surgery. However, whether it is necessary to perform the ileostomy is still controversial. This meta-analysis aims to analyze the efficacy of ileostomy on laparoscopic rectal cancer surgery. Methods Cochrane Library, EMBASE, Web of Science, and PubMed were applied for systematic search of all relevant literature, updated to May 07, 2021. Studies compared patients with and without ileostomy for laparoscopic rectal cancer surgery. We applied Review Manager software to perform this meta-analysis. The quality of the non-randomized controlled trials was assessed using the Newcastle-Ottawa scale (NOS), and the randomized studies were assessed using the Jadad scale. Results We collected a total of 1203 references, and seven studies were included using the research methods. The clinically significant anastomotic leakage rate was significantly lower in ileostomy group (27/567, 4.76%) than that in non-ileostomy group (54/525, 10.29%) (RR = 0.47, 95% CI 0.30–0.73, P for overall effect = 0.0009, P for heterogeneity = 0.18, I2 = 32%). However, the postoperative hospital stay, reoperation, wound infection, and operation time showed no significant difference between the ileostomy and non-ileostomy groups. Conclusion The results demonstrated that protective ileostomy could decrease the clinically significant anastomotic leakage rate for patients undergoing laparoscopic rectal cancer surgery. However, ileostomy has no effect on postoperative hospital stay, reoperation, wound infection, and operation time. The efficacy of ileostomy after laparoscopic rectal cancer surgery: a meta-analysis.

scholarly journals Nomogram Prediction of Anastomotic Leakage and Determination of an Effective Surgical Strategy for Reducing Anastomotic Leakage after Laparoscopic Rectal Cancer Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Chang Hyun Kim ◽  
Soo Young Lee ◽  
Hyeong Rok Kim ◽  
Young Jin Kim
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Rectal Adenocarcinoma ◽  
Operation Time ◽  
Tumor Location ◽  
Cancer Surgery ◽  
Individual Risk ◽  
Calibration Plot ◽  
Rectal Cancer Surgery ◽  
Surgical Strategies

Background. Although many surgical strategies have been used to reduce the anastomotic leak (AL) rate after laparoscopic rectal cancer surgery, limited data are available on the risk factors for AL and the effective strategy to reduce AL. Methods. The present study enrolled 736 consecutive patients who underwent laparoscopic resection without a diverting stoma for rectal adenocarcinoma. A nomogram was constructed to predict AL. Based on the nomogram, personalized risk was calculated and sequential surgical strategies were monitored using risk-adjusted cumulative sum (RA-CUSUM) analysis. Results. Among the 736 patients, clinical AL occurred in 65 patients (8.8%). Sex, an American Society of Anesthesiologists score, operation time, blood transfusion, and tumor location were identified as significant predictive factors for AL. Based on these factors, a nomogram was created to predict AL, with a concordance index (C-index) of 0.753 (95% confidence interval, 0.690–0.816). A calibration plot showed good statistical performance on internal validation (bias-corrected C-index of 0.742). The RA-CUSUM curve showed that extended splenic flexure mobilization (SFM) could be the most influential strategy to reduce AL. Conclusions. Our nomogram for predicting AL after laparoscopic rectal cancer surgery might be helpful to identify the individual risk of AL. Furthermore, extended SFM might be the most appropriate strategy for reducing AL.

scholarly journals Low ligation has a lower anastomotic leakage rate after rectal cancer surgery

2020 ◽  
Vol 12 (6) ◽  
pp. 632-641
Author(s):  
Jia-Nan Chen ◽  
Zheng Liu ◽  
Zhi-Jie Wang ◽  
Fu-Qiang Zhao ◽  
Fang-Ze Wei ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Leakage Rate ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Anastomotic Leakage Rate ◽  
Low Ligation

scholarly journals Influence of Conversion and Anastomotic Leakage on Survival in Rectal Cancer Surgery; Retrospective Cross-sectional Study

2018 ◽  
Vol 23 (10) ◽  
pp. 2007-2018 ◽  
Author(s):  
Edgar J. B. Furnée ◽  
◽  
Tjeerd S. Aukema ◽  
Steven J. Oosterling ◽  
Wernard A. A. Borstlap ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Cross Sectional Study ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Leakage after Surgery for Rectum Cancer: Inconsistency in Reporting to the Danish Colorectal Cancer Group

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
L. Borly ◽  
M. B. Ellebæk ◽  
N. Qvist
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Leakage Rate ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Prognostic Impact ◽  
Cancer Specific Survival ◽  
Cancer Group ◽  
Core Questions

Purpose. Anastomotic leakage accounts for up to 1/3 of all fatalities after rectal cancer surgery. Evidence suggests that anastomotic leakage has a negative prognostic impact on local cancer recurrence and long-term cancer specific survival. The reported leakage rate in 2011 in Denmark varied from 7 to 45 percent. The objective was to clarify if the reporting of anastomotic leakage to the Danish Colorectal Cancer Group was rigorous and unequivocal.Methods. An Internet-based questionnaire was e-mailed to all Danish surgical departments, who reported to Danish Colorectal Cancer Group (DCCG) in 2011. There were 23 questions. Four core questions were whether pelvic collection, fecal appearance in a pelvic drain, rectovaginal fistula, and “watchfull” waiting patients were reported as anastomotic leakage.Results. Fourteen out of 17 departments, who in 2011 according to DDCG performed rectal cancer surgery, answered the questionnaire. This gave a response rate of 82%. In three of four core questions there was disagreement in what should be reported as anastomotic leakage.Conclusion. The reporting of anastomotic leakage to the Danish Colorectal Cancer Group was not rigorous and unequivocal. The reported anastomotic leakage rate in Danish Colorectal Cancer Group should be interpreted with caution.

Early transanal closure after vacuum‐assisted drainage for anastomotic leakage in rectal cancer surgery – a video vignette

2020 ◽  
Vol 22 (8) ◽  
pp. 973-974 ◽  
Author(s):  
K. Talboom ◽  
J. Kesteren ◽  
D. J. A. Sonneveld ◽  
P. J. Tanis ◽  
W. A. Bemelman ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Video Vignette

scholarly journals The use of robotic or laparoscopic stapler in rectal cancer surgery: a systematic review and meta-analysis

2020 ◽  
Vol 14 (6) ◽  
pp. 829-833
Author(s):  
Patricia Tejedor ◽  
Filippos. Sagias ◽  
Karen Flashman ◽  
Ngianga Li Kandala ◽  
Jim Khan
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Meta Analysis ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery
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