■建议进行直肠冲洗以消除游离癌细胞,然而,关于其预防前切除术后局部复发的有效性的证据尚无定论.
■对比直肠癌的直肠冲洗(RW)和非直肠冲洗(NRW),2005年1月至2023年7月,使用PubMed进行了一项随机对照试验(RCT)和非随机对照试验(NRCT)的前瞻性研究,科克伦图书馆,和MEDLINE数据库。RevMan5.4中的荟萃统计分析解决了异质性。
■在涉及19,855名患者的分析中(15127RW,4728NRW)来自八项研究,RW显著降低局部复发(OR=0.48),术中RW(OR=0.65),根治性切除边缘(OR=1.89),和新辅助治疗(OR=0.99)(均p<0.05)。亚组RCT分析加强了这些发现。
■直肠冲洗与改善的结果相关,而非冲洗患者从新辅助治疗中获益更多。值得注意的是,没有新辅助的直肠冲洗仍然有效。
UNASSIGNED: Rectal washout is proposed for eliminating free cancer cells, yet evidence on its efficacy in preventing local recurrence after anterior resection is inconclusive.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: Rectal washout correlates with improved outcomes, while non-washout patients benefit more from neoadjuvant therapy. Notably, rectal washout without neoadjuvant remains efficacious.