Intra-operative rectal washout can effectively prevent local tumor recurrence: a Meta-analysis / 肿瘤研究与临床

ABSTRACT

Objective To investigate the effect of rectal washout on prevention of local recurrence in patients with resectable rectal cancer.Methods Relevant studies published on PubMed,Embase database and Google between January 1980 and June 2013 were identified and reviewed.A meta-analysis was performed to compute the risk ratio (RR) and evaluate the effect of rectal washout on local recurrence in patients included in the reviewed studies.Results Eight studies were included in the meta-analysis,in which a total of 427 patients underwent rectal washout and 492 did not during rectal cancer resection.The patients had an overall local recurrence (LR) rate of 6.64 ％ (61/919).Rectal washout,no matter which type of washout solution was used,significantly reduced the risks of local recurrence (3.75 ％,16/427 vs 9.15 ％,45/492,RR =0.46,95 ％ CI =0.26-0.82,P =0.008).Patients with rectal washout showed a low LR rate,when compared with those in the three subgroups who underwent total mesorectal excision (TME) (5.18 ％,10/193 vs 5.32 ％,10/188).However,there was no statistically significant difference in the risk of LR among the three subgroups (RR =0.99,95 ％ CI =0.42-2.30,P =0.98; RR =0.44,95 ％ CI =0.18-1.04,P =0.06; RR =0.46,95 ％ CI =0.20-1.04,P =0.06,respectively).Conclusions The intra-operative rectal washout largely reduces local recurrence after anterior resection of rectal cancer.Rectal washout should be applied routinely during anterior resection.