scholarly journals Association between Irrigation Fluids, Washout Volumes and Risk of Local Recurrence of Anterior Resection for Rectal Cancer: A Meta-Analysis of 427 Cases and 492 Controls

PLoS ONE ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. e95699 ◽  
Author(s):  
Can Zhou ◽  
Yu Ren ◽  
Juan Li ◽  
Ke Wang ◽  
Jianjun He ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Anterior Resection ◽  
Meta Analysis

scholarly journals SP1.2.12A meta-analysis of the impact of rectal washout on local recurrence following anterior resection for rectal cancers

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Hena Hidayat ◽  
Tara Connelly ◽  
Anil Agarwal ◽  
Talvinder Gill ◽  
Venkatesh Shanmugam ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Anterior Resection ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Rectal Washout ◽  
Significant Difference ◽  
Rectal Cancers ◽  
The Impact

Abstract Background Standardisation of surgical technique in form of total mesorectal excision (TME) and the use of preoperative radiotherapy have led to improved oncological outcomes in rectal cancer. However, the effectiveness of rectal washout in reducing local recurrence (LR) following anterior resection remains debatable. The aim of this meta-analysis was to evaluate the effectiveness of rectal washout in reducing incidence of LR after anterior resection for rectal cancer. Methods A literature search of electronic databases including PubMed, Embase, Scopus and Cochrane was performed for studies that compared rectal washout to no washout after anterior resection using TME for rectal cancers. The review included all articles reporting oncological outcome of local recurrence. Meta-analysis was carried out using random effect model. Results A total of 5 studies involving 5315 patients were included in meta-analysis. Median follow-up was 60 (range 33–60) months. Overall local recurrence rate was 6.6 % with no significant difference in LR rate between the rectal washout and no washout groups (5.23% vs. 9 %)(P = 0.93; RR 0.97; 95% CI 0.52- 1.83).Similarly in subgroup analysis including prospective studies only no significant difference in LR was seen after washout (P = 0.06) or in group of patients treated with a curative intent(P = 0.50). LR was significantly lower in patients who had a rectal washout with normal saline (P < 0.00001; RR 0.59; 95% CI 0.47-0.74). Conclusion This meta-analysis shows that there is no benefit of rectal washout in reducing incidence of local recurrence after anterior resection for rectal cancers.

Survival and local recurrence after anterior resection and abdominoperineal excision for rectal cancer

1995 ◽  
Vol 21 (6) ◽  
pp. 640-643 ◽  
Author(s):  
Jörg Tschmelitsch ◽  
Peter Kronberger ◽  
Rupert Prommegger ◽  
Gilbert Reibenegger ◽  
Karl Glaser ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Anterior Resection ◽  
Abdominoperineal Excision

scholarly journals Protective Diversion Stoma in Low Anterior Resection for Rectal Cancer: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 35 (3) ◽  
pp. 156-160 ◽  
Author(s):  
Pankaj Kumar Garg ◽  
Aakanksha Goel ◽  
Sneha Sharma ◽  
Nilokali Chishi ◽  
Manish Kumar Gaur
Keyword(s):  
Rectal Cancer ◽  
Randomized Controlled Trials ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Diversion Stoma

Pushing the envelope beyond a centimeter in rectal cancer: Oncologic implications of close but negative margins.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 487-487
Author(s):  
T. L. Fitzgerald ◽  
J. Brinkley ◽  
E. E. Zervos
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Adjuvant Therapy ◽  
Adjuvant Radiotherapy ◽  
Meta Analysis ◽  
Sphincter Preservation ◽  
Distal Margin ◽  
Recurrence Rates ◽  
Randomized Controlled Studies ◽  
Number Of Patients

487 Background: Advances in surgery, adjuvant therapy and understanding of the natural history of rectal cancer has enabled sphincter preservation surgery for most patients. A 1 cm margin is commonly accepted as minimal distal margin, when not achievable many are relegated to permanent colostomy. Our purpose was to determine if distal margins of < 1 cm is justified by the world's published experience. Methods: Studies were identified with a MEDLINE search using terms rectal cancer, colorectal cancer, margins and distal margins with an additional manual search. There were no restrictions on data type or year of publication. All studies were retrospective or prospective, none were randomized controlled. Studies were excluded if specific margins, local recurrence rates or case level data could not be extracted. Extracted variables included year of publication, time span, number of patients, standardized surgery, radiotherapy, margins, follow up, local recurrence rates and overall survival. Meta-analysis was performed using a random weighting scheme. Values were aggregated across studies to determine overall impact and p-values. Results: Seventeen studies reported margins with thirteen studies, 3,232 patients, reporting outcomes when < 1cm. Meta-analysis of all studies indicated a nonsignificant trend favoring greater margins. However, in order to understand distal margins in the context of current standards additional analyses were performed. Of the thirteen studies 4 reported neither TME nor use adjuvant radiotherapy and 9 studies reported use of one or both. When either total mesorectal excision and/or adjuvant radiotherapy was reported there was no significant increase in local recurrence with distal margins < 1 cm. In studies that used neither therapy > 1 cm margins were statistically less prone to recurrence. Conclusions: Sphincter preservation is possible with < 1 cm distal margin when optimal surgical and adjuvant therapy are applied. [Table: see text]

scholarly journals The effect of rectal washout on local recurrence following rectal cancer surgery

2018 ◽  
Vol 100 (2) ◽  
pp. 146-151 ◽  
Author(s):  
SR Moosvi ◽  
K Manley ◽  
J Hernon
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Anterior Resection ◽  
High Volume ◽  
Conclusive Evidence ◽  
Rectal Cancer Surgery ◽  
Single Institution ◽  
Recurrence Rates ◽  
Rectal Washout ◽  
Significant Difference

Introduction Local recurrence after surgery for rectal cancer is associated with significant morbidity and debilitating symptoms. Intraoperative rectal washout has been linked to a reduction in local recurrence but there is no conclusive evidence. The aim of this study was to evaluate whether performing rectal washout had any effect on the incidence of local recurrence in patients undergoing anterior resection for rectal cancer in the context of the current surgical management. Methods A total of 395 consecutive patients who underwent anterior resection with or without rectal washout for rectal cancer between January 2003 and July 2009 at a high volume single institution were analysed retrospectively. A standardised process for performing washout was used and all patients had standardised surgery in the form of total mesorectal excision. Neoadjuvant and adjuvant therapy was used on a selected basis. Patients were followed up for five years and local recurrence rates were compared in the two groups. Results Of the 395 patients, 297 had rectal washout and 98 did not. Both groups were well matched with regard to various important clinical, operative and histopathological characteristics. Overall, the local recurrence rate was 5.3%. There was no significant difference in the incidence of local recurrence between the washout group (5.7%) and the no washout group (4.1%). Conclusions Among our cohort of patients, there was no statistical difference in the incidence of local recurrence after anterior resection with or without rectal washout. This suggests that other factors are more significant in the development of local recurrence.

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