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

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

doi:10.5114/wiitm.2024.138732

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abstract:

Original paper

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

Linhai Meng

¹

,

Chen Zhuming

¹

,

Huaiwen Xu

¹

,

Chaohui Wang

¹

,

Shuangjiu Hu

¹

,

Zhe Kai

¹

Department of General Surgery, Anqing First People’s Hospital of Anhui Medical University, Anqing, China

Videosurgery Miniinv 2024; 19 (2): 129–140

DOI: https://doi.org/10.5114/wiitm.2024.138732

Online publish date: 2024/04/09

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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.

keywords:

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

Linhai Meng 1 , Chen Zhuming 1 , Huaiwen Xu 1 , Chaohui Wang 1 , Shuangjiu Hu 1 , Zhe Kai 1

rectal cancer, rectal washout, local recurrence, quality of life, meta-analysis

Linhai Meng

¹

,

Chen Zhuming

¹

,

Huaiwen Xu

¹

,

Chaohui Wang

¹

,

Shuangjiu Hu

¹

,

Zhe Kai

¹