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European Surgery
Erschienen in:

02.04.2019 | review

Simultaneous versus staged resection of rectal cancer and synchronous liver metastases (RESECT)

A systematic review and meta-analysis

verfasst von: Andrew E. Giles, Marlie Valencia, Sameer Parpia, Erin Fu, Leyo Ruo, Marko Simunovic, Dr. Pablo E. Serrano

Erschienen in: European Surgery | Ausgabe 1/2020

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Summary

Background

Staged resection is preferred to treat synchronous rectal cancer with liver metastases. Simultaneous resection of rectal cancer with synchronous liver metastases may potentially decrease postoperative complications, thereby improving quality of life, decreasing health care costs, and avoiding delays in postoperative chemotherapy administration. We evaluated the safety of simultaneous resection.

Methods

We searched Medline, Embase, and PubMed for studies comparing simultaneous versus staged resection. Study selection, data abstraction, risk of bias (ROB), and quality of the evidence (QOE) assessment were performed in duplicate. The primary outcome was overall postoperative complications. The secondary outcome was postoperative complications in the intervention group. ROB and QOE were assessed using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).

Results

4456 abstracts were retrieved; 18 retrospective cohort studies reported postoperative complications in the intervention arm, with six comparing intervention (288 patients) to control (287 patients). The odds ratio (OR) for overall complications was 0.93, 95% confidence interval (CI): 0.64–1.35, and for major complications was 0.77, 95%CI: 0.40–1.50. Proportion of complications (intervention arm): 41%, 95%CI: 33–50%. ROB was moderate.

Discussion

Simultaneous resection of synchronous rectal cancer with liver metastases carries a similar risk of overall and major complications compared to the staged approach. However, QOE is very low and a simultaneous approach ought to be pursued only in selected patients until better evidence is available.
Vorheriger Artikel Surgery 2020 approximates the essence of disease, being and atmosphere
Nächster Artikel Robotic multiport versus robotic single-site cholecystectomy: a retrospective single-centre experience of 142 cases
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Metadaten
Titel
Simultaneous versus staged resection of rectal cancer and synchronous liver metastases (RESECT)
A systematic review and meta-analysis
verfasst von
Andrew E. Giles
Marlie Valencia
Sameer Parpia
Erin Fu
Leyo Ruo
Marko Simunovic
Dr. Pablo E. Serrano
Publikationsdatum
02.04.2019
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 1/2020
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-019-0582-0

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