End-to-end anastomosis provides similar quality-of-life, compared with other reconstructive techniques six months following total mesorectal excision: Systematic review and meta-analysis.

Colorectal anastomosis LARS Rectum resection Straight colorectal anastomosis low anterior resection

Journal

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356

Informations de publication

Date de publication:
10 Aug 2024
Historique:
received: 25 05 2024
accepted: 09 08 2024
medline: 19 8 2024
pubmed: 19 8 2024
entrez: 18 8 2024
Statut: aheadofprint

Résumé

Colorectal malignancy ranked third globally in cancer incidence with 1.9 million cases and nearly 1 million deaths in 2020. Rectal cancer is primarily treated with total mesorectal excision (TME). This study examines surgical, functional, and quality-of-life (QoL) outcomes for different anastomosis types. Pre-registered on PROSPERO (CRD42022368907), the systematic search on November 8, 2022, covered three databases: MEDLINE (via PubMed), Embase, and Cochrane Central. Randomized controlled trials (RCT) assessing adults post-TME, comparing end-to-end anastomosis (EEA) to colonic J-pouch (CJP) and/or side-to-end anastomosis (SEA) were eligible. 29 studies out of 4459 were included. EEA vs. CJP showed no significant differences in anastomotic leakage (AL) (RR: 1.03; CI: [0.84-1.26]) or mortality (RR: 0.77; CI: [0.30-1.98]). At 12 months, the mean bowel movement difference was 1.59/day (CI: [(-)0.66-3.84]). QoL at six and 12 months was similar (SMD: -0.22; CI: [(-)0.82-0.37]). Compared with SEA, EEA had similar AL ratios (RR: 1.59; CI: [0.54-4.72]) and QoL at six months (SMD: -0.04; CI: [(-)0.66-0.58]). EEA demonstrates surgical efficacy comparable to other techniques. Six months postoperatively, EEA's impact on QoL appears similar to CJP or SEA, irrespective of daily stool frequency.

Identifiants

DOI: 10.1016/j.ejso.2024.108599 PMID: 39154431
pubmed: 39154431
pii: S0748-7983(24)00651-6
doi: 10.1016/j.ejso.2024.108599
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

108599

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None. We confirm that the material in this paper has not been previously published or submitted elsewhere, and we commit not to submit it to another journal until a publication decision is reached; all authors have approved the final version and signed the Author Form via DocuSign, declare no conflicts of interest, and conducted this meta-analysis without external funding or potential financial or material influences.

Auteurs

Sarolta Beáta Kávási (SB)

Semmelweis University, Centre for Translational Medicine, Tűzoltó street 37-47, 1094, Budapest, Hungary; Toldy Ferenc Hospital, Department of Surgery, Törteli street 1-3, 2700, Cegléd, Hungary. Electronic address: kavasisarolta@yahoo.com.

Diana-Elena Iov (DE)

Semmelweis University, Centre for Translational Medicine, Tűzoltó street 37-47, 1094, Budapest, Hungary; Grigore T. Popa University of Medicine and Pharmacy, Universității street 16, 700115, Iași, Romania. Electronic address: iovdiana95@gmail.com.

Anett Rancz (A)

Semmelweis University, Centre for Translational Medicine, Tűzoltó street 37-47, 1094, Budapest, Hungary; Semmelweis University, Medical School, Department of Internal Medicine and Hematology, Szentkirályi street 46, 1088, Budapest, Hungary. Electronic address: rancz.anett@gmail.com.

Ádám Zolcsák (Á)

Semmelweis University, Centre for Translational Medicine, Tűzoltó street 37-47, 1094, Budapest, Hungary; Semmelweis University, Department of Biophysics and Radiation Biology, Tűzoltó street 37-47, 1094, Budapest, Hungary. Electronic address: zolcsak.adam@semmelweis.hu.

Dániel Sándor Veres (DS)

Semmelweis University, Centre for Translational Medicine, Tűzoltó street 37-47, 1094, Budapest, Hungary; Semmelweis University, Department of Biophysics and Radiation Biology, Tűzoltó street 37-47, 1094, Budapest, Hungary. Electronic address: veres.daniel@med.semmelweis-univ.hu.

Katalin Lenti (K)

Semmelweis University, Centre for Translational Medicine, Tűzoltó street 37-47, 1094, Budapest, Hungary; Semmelweis University, Faculty of Health Sciences, Department of Morphology and Physiology, Vas street 17, 1088, Budapest, Hungary. Electronic address: lenti.katalin@semmelweis.hu.

Pál Miheller (P)

Semmelweis University, Centre for Translational Medicine, Tűzoltó street 37-47, 1094, Budapest, Hungary; Semmelweis University, Department of Surgery, Transplantation, and Gastroenterology, Üllői street 78, 1082, Budapest, Hungary. Electronic address: pmiheller@gmail.com.

Péter Hegyi (P)

Semmelweis University, Centre for Translational Medicine, Tűzoltó street 37-47, 1094, Budapest, Hungary; University of Pécs, Medical School, Institute for Translational Medicine, Szigeti street 12, 2nd floor, 7624, Pécs, Hungary; Semmelweis University, Institute of Pancreatic Diseases, Tömő street 25-29, 1083, Budapest, Hungary. Electronic address: hegyi2009@gmail.com.

Szabolcs Ábrahám (S)

Semmelweis University, Centre for Translational Medicine, Tűzoltó street 37-47, 1094, Budapest, Hungary; University of Szeged, Department of Surgery, Semmelweis street 8, 6725, Szeged, Hungary. Electronic address: abraham.szabolcs@med.u-szeged.hu.

Classifications MeSH