The impact of anastomotic leakage on oncology after curative anterior resection for rectal cancer: A systematic review and meta-analysis.
Medicine (Baltimore)
; 99(37): e22139, 2020 Sep 11.
Article
em En
| MEDLINE
| ID: mdl-32925766
ABSTRACT
BACKGROUND:
Anastomotic leakage (AL) is a serious clinical complication after anterior resection for rectal cancer and will lead to an increase in postoperative mortality. However, the effect on long-term oncology outcomes remains controversial.METHODS:
We searched the PubMed, Embase, and Cochrane library databases for related articles. The included studies assessed local recurrence, distant recurrence, overall survival, cancer-specific survival and disease-free survival. The systematic reviews and meta-analyses was conducted in accordance with the PRISMA guidelines. The combined RRs with 95% CI were then calculated using a fixed effects model or a randomized effect model.RESULTS:
A total of 18 cohort studies included 34,487 patients who met the inclusion criteria. The meta-analysis demonstrated that AL was associated with increased local recurrence (RR 1.47, 95% CI 1.14-1.90, Iâ=â57.8%). Anastomotic leakage decreased overall survival (RR 0.92, 95% CI 0.88-0.96, Iâ=â58.1%), cancer-specific survival (RR 0.96, 95% CI 0.92-1.00, Iâ=â30.4%), and disease-free survival (RR 0.85, 95% CI 0.77-0.94, Iâ=â80.4%). Distant recurrence may had no significant effects of AL (RR 1.16, 95% CI 0.91-1.46, Iâ=â58.4%).CONCLUSION:
AL has a negative effect on local recurrence and long-term survival (including overall survival, cancer-specific survival, and disease-free survival) after anterior resection for rectal cancer, but not related to distant recurrence.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
/
Fístula Anastomótica
Tipo de estudo:
Clinical_trials
/
Guideline
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Limite:
Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article