直肠癌切除术时直肠灌洗与局部复发的关系：荟萃分析

Rectal washout and local recurrence in rectal resection for cancer: a meta-analysis.

机构信息

Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy.

出版信息

Colorectal Dis. 2012 Nov;14(11):1313-21. doi: 10.1111/j.1463-1318.2011.02903.x.

DOI:10.1111/j.1463-1318.2011.02903.x

PMID:22150936

Abstract

AIM

The effectiveness of rectal washout was compared with no washout for the prevention of local recurrence after anterior rectal resection for rectal cancer.

METHOD

The following electronic databases were searched: PubMed, OVID Medline, Cochrane Database of Systematic Reviews, EBM Reviews, CINAHL and EMBASE.

RESULTS

Five nonrandomized studies including a total of 5012 patients were identified. Meta-analysis suggested that rectal washout significantly reduced the local recurrence rate (P < 0.0001; OR 0.57; 95% CI 0.43-0.74). It was also significantly lower after washout in patients having radical resection only (P = 0.0004; OR 0.54; 95% CI 0.39-0.76), patients treated by a curative resection (P < 0.0001; OR 0.55; 95% CI 0.42-0.72) and those undergoing preoperative radiotherapy (P = 0.04; OR 0.62; 95% CI 0.39-0.98).

CONCLUSION

Taking into account the limitations of the design of the included studies the meta-analysis showed that rectal washout is associated with reduced local recurrence and therefore should be routine during anterior resection for rectal cancer.

摘要

目的

比较直肠癌前切除术后直肠冲洗与不冲洗对预防局部复发的效果。

方法

检索了以下电子数据库：PubMed、OVID Medline、Cochrane 系统评价数据库、EBM Reviews、CINAHL 和 EMBASE。

结果

共纳入 5 项非随机研究，总计 5012 例患者。Meta 分析表明，直肠冲洗显著降低了局部复发率（P<0.0001；OR 0.57；95%CI 0.43-0.74）。仅行根治性切除术（P=0.0004；OR 0.54；95%CI 0.39-0.76）、根治性切除术（P<0.0001；OR 0.55；95%CI 0.42-0.72）和术前放疗（P=0.04；OR 0.62；95%CI 0.39-0.98）的患者，冲洗后局部复发率也显著降低。