Postoperative outcomes in patients undergoing Total Pelvic Clearance for locally advanced Primary and Recurrent Rectal Cancer: A Systematic Review to assess Perioperative Mortality, Rate of R0 Resection and 5Year Overall Mortality
Khan, R. Selvasekar, Chelliah Jamshed, N. Sahu, A.
Khan, R.
Selvasekar, Chelliah
Jamshed, N.
Sahu, A.
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Abstract
Introduction: The outcomes of complex surgical procedures such as
Total pelvic clearance (TPC) have improved due to advances in
technology, improvements in surgical technique and experience.
Majority of Reviews include older studies diluting the bene
fits and
outcomes. Secondly, very few studies mention all important outcomes
in one leading to non-uniformity in reporting of data. Lastly, there
was further need of updating the previous reviews, the last one
published a decade earlier, hence, the review of Perioperative
Mortality, rates of R0 resection and 5-year overall survival were
carried out in patients undergoing TPC for primary or recurrent rectal
cancer in a systematic manner.
Methods: Literature searches were performed in three databases:
MEDLINE, PUBMED and Cochrane Library. Each study was evaluated
with regards to its design and statistical methodology. The quality
assessment of studies was carried out in this review as per the SIGN
grading system. Publication bias was assessed by drawing funnel plots
for each outcome. Each outcome was further analysed by creating
Forrest plot using
fixed effect model.
Results: A total of 1632 articles were identi
fied through electronic
databases. A total of 21 articles were
finally included which met the
inclusion and exclusion criteria. Out of 963 resections carried out,
perioperative mortality was 3.4%. Overall R0 rection rates were 72.4%.
Out of total 374 patients, overall, 5-year survival rate was 42%.
Conclusion: TPC is safe in experienced hands at specialist centres
experienced in dealing with such cases with acceptable outcomes
outlined above
Affiliation
Description
Date
2022
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Khan R, Selvasekar C, Jamshed N, Sahu A. Postoperative outcomes in patients undergoing Total Pelvic Clearance for locally advanced Primary and Recurrent Rectal Cancer: A Systematic Review to assess Perioperative Mortality, Rate of R0 Resection and 5Year Overall Mortality. British Journal of Surgery. 2022 Aug;109. PubMed PMID: WOS:000843334600495.