Clinical efficacy and safety of laparoscopic abdominoperineal resection with pelvicperitoneum colsure for low rectal cancer:a meta-analysis
10.3969/j.issn.1009-9905.2025.04.004
- VernacularTitle:腹腔镜腹会阴联合切除术中关闭盆底腹膜的Meta分析
- Author:
Fei GAO
1
;
Bin HAN
;
Hao-yong ZHAO
;
Yong-han ZHANG
;
Mao-sen GUO
;
Hao WANG
;
Shang-jie GUO
Author Information
1. 郑州大学第二附属医院 普通外科(河南 郑州 450014)
- Publication Type:Journal Article
- Keywords:
Rectal cancer;
Abdominoperineal resection,laparoscopic;
Pelvicperitoneum colsure;
Meta analysis
- From:
Chinese Journal of Current Advances in General Surgery
2025;28(4):271-278
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigatetheclinicalefficacy and satetyoflaparoscopic abdominoperineal resection with pelvicperitoneum colsure for low rectal cancer.Methods:A comprehesive search was conducted across multiple da-tabases,including the Cochrane Library、PubMed、Embase、CBM、VIP、CNKI、and WanFang Data,focusing on studies re-lated to pelvic peritoneum colsure(PPC)-oriented laparoscopic abdominoperineal resection from database inception to July,2024.Then,meta-analysis was performed using RevMan 5.3 software.Results:A total of 12 studies involving 999 patients were included.The results showed that there was no significant difference in intraoperative blood loss.The laparoscopic pelvicperitoneum colsure takes a longer time,with a statistically significant difference(WMD=12.37,95%CI=2.27～22.46,P=0.02),but the postoperative exhaust time and hospitalization time are shorter,with a statistically significant difference(WMD=0.40,95%CI=0.07～0.72,P=0.02;WMD=-2.36,95%CI=-3.33～-1.38,P＜0.00001).In terms of postoperative complications,the overall complication rate was higher in the group that did not undergo pelvic-peritoneum colsure,with a statistically significant difference(OR=0.12,95%CI=0.08～0.18,P＜0.00001).The incidence of postoperative intestinal obstruction,perineal incisional hernia,pelvic effusion infection,and radiation enteritis was higher,and the differences were statistically significant(OR=0.24,95%CI=0.13～0.45,P＜0.00001,OR=0.23,95%CI=0.11～0.49,P=0.0001,OR=0.27,95%CI=0.14～0.51,P＜0.0001,OR=0.24,95%CI:0.07～0.81,P=0.03).Conclusion:In lapa-roscopic abdominoperineal resection,closing the pelvicperitoneum has lower postoperative complications,shorter post-operative exhaust time and hospitalization time,and longer operation time,which has better clinical efficacy and safety.
