Oncologic Impact of Anastomotic Leakage Following Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis.

Ha, Gi Won; Kim, Jong Hun; Lee, Min Ro
Annals of surgical oncology
2017Jun ; 56 ( 25 ) :.
저자 상세정보
Ha, Gi Won -
Kim, Jong Hun -
Lee, Min Ro -
ABSTRACT
BACKGROUND: Anastomotic leakage (AL) is a major complication of surgery for colorectal cancer (CRC), and is associated with increased morbidity and mortality; However, there are conflicting results on the impact of AL on long-term oncologic outcomes. OBJECTIVE: The aim of this meta-analysis was to assess the oncologic outcomes of AL following restorative surgery for CRC.

METHODS: Multiple comprehensive databases, including PubMed, EMBASE, and The Cochrane Library, were searched for studies that assessed the oncologic effects of AL following surgery for CRC. The included studies evaluated local and distant recurrence, overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Outcome data were pooled, and overall effect size was calculated using random effects models.

RESULTS: Thirty-four nonrandomized studies including 78,434 patients met the inclusion criteria. The results show that AL was associated with increased local recurrence (relative risk [RR] 1.90, 95% confidence interval [CI] 1.48-2.44, I (2)?=?78%) and reduced OS (RR 1.36, 95% CI 1.24-1.50, I (2)?=?74%), CSS (RR 1.41, 95% CI 1.19-1.68, I (2)?=?56%), and DFS (RR 1.40, 95% CI 1.20-1.63, I (2)?=?86%). AL had no significant effect on distant recurrence (RR 1.20, 95% CI 0.94-1.53, I (2)?=?61%).

CONCLUSIONS: AL after restorative surgery for CRC is associated with increased local recurrence and reduced long-term survival, including OS, CSS, and DFS.
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링크

주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
AL after restorative surgery for CRC is associated with increased local recurrence and reduced long-term survival, including OS, CSS, and DFS.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
DOI
10.1245/s10434-017-5881-8
KCD코드
ICD 03
건강보험코드