Perineal Wound Closure Following Abdominoperineal Resection and Pelvic Exenteration for Cancer: A Systematic Review and Meta-Analysis
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Search Strategy and Data Collection
2.2. Inclusion and Exclusion Criteria
2.3. Outcome Parameters
2.4. Data Collection and Extraction
2.5. Quality Assessment
2.6. Statistical Analysis
3. Results
3.1. Literature Search and Results
3.2. Study and Patient Characteristics
3.3. Study Endpoints
3.4. Total Perineal Wound Complication
3.5. Major Wound Complications
3.6. Minor Wound Complications
3.7. Length of Stay
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Study (Author) | Year | Country | Design | Quality * | Disease | Patient (n = 2180) | Primary Closure ** (n = 1206) | Flap closure ** (n = 647) | Mesh Closure ** (n = 327) |
---|---|---|---|---|---|---|---|---|---|
Ghouti et al. [21] | 2005 | France | Retrospective cohort study | 5 | Anal cancer | 41 | 15 | 26 | - |
Chessin et al. [6] | 2005 | USA | Retrospective cohort study | 5 | Rectal cancer and anal cancer | 78 | 59 | 19 | - |
Butler et al. [7] | 2008 | USA | Retrospective cohort study | 5 | Rectal and anal cancer | 111 | 76 | 35 | - |
Lefevre et al. [22] | 2009 | France | Retrospective cohort study | 7 | Anal cancer | 95 | 52 | 43 | - |
Chan et al. [23] | 2010 | UK | Retrospective cohort study | 4 | Rectal cancer | 51 | 21 | 30 | - |
Stelzner et al. [24] | 2011 | Germany | Retrospective cohort study | 3 | Rectal cancer | 74 | 46 | 28 | - |
Jacombs et al. [33] | 2012 | Australia | Retrospective cohort study | 5 | Rectal cancer | 203 | 164 | 39 | - |
Chokshi et al. [32] | 2013 | USA | Retrospective cohort study | 5 | Rectal cancer, anal cancer, and other cancers | 53 | 36 | 17 | - |
Davidge et al. [25] | 2014 | Canada | Retrospective cohort study | 4 | Rectal cancer | 177 | 125 | 52 | - |
O’Dowd et al. [27] | 2014 | Ireland | Retrospective cohort study | 8 | Rectal cancer | 39 | 27 | 12 | - |
Touny et al. [28] | 2014 | Egypt | RCT | 9 | Rectal cancer | 60 | 30 | 30 | - |
Althumairi et al. [26] | 2015 | USA | Retrospective cohort study | 4 | Rectal cancer | 67 | 56 | 11 | - |
Woodfield et al. [29] | 2017 | New Zeland | Retrospective cohort study | 3 | Rectal cancer, anal cancer, and other cancers | 68 | 37 | 31 | - |
Chaudhry et al. [30] | 2018 | USA | Retrospective cohort study | 5 | Rectal cancer, anal cancer, and other cancers | 562 | 288 | 274 | - |
Han et al. # [31] | 2014 | China | RCT | 9 | Rectal cancer | 102 | 19 | - | 83 |
Musters et al. # [10] | 2017 | Netherlands | RCT | 9 | Rectal cancer | 101 | 53 | - | 48 |
Habr-Gama et al. # [18] | 2017 | Brazil | Retrospective cohort study | 6 | Rectal cancer | 72 *** | 48 | - | 22 |
Han et al. # [9] | 2019 | China | Retrospective cohort study | 6 | Rectal cancer | 228 | 54 | - | 174 |
Flap and Primary Closure (n = 1679) | Mesh and Primary Closure (n = 501) | |||||
---|---|---|---|---|---|---|
Flap (n = 647) * | Primary Closure (n = 1032) | Total (n = 1679) | Mesh (n = 327) | Primary Closure (n = 174) | Total (n = 501) | |
Sex | ||||||
Male | 463 (77%) | 716 (69%) | 1179 (70%) | 164 (37%) | 67 (38%) | 319 (63%) ** |
NR | 35 (5%) | 76 (7%) | 312 (32%) | 67 (38%) | 0 | |
Disease *** | ||||||
Rectal cancer | 256 (40%) | 623 (60%) | 879 (53%) | 327 (100%) | 174 (100%) | 501 (100%) |
Anal Cancer | 88 (13%) | 72 (7%) | 160 (9%) | 0 | 0 | 0 |
Other cancers | 11 (2%) | 0 | 11 (0.5%) | 0 | 0 | 0 |
NR | 292 (45%) | 337 (33%) | 629 (37.5%) | 0 | 0 | 0 |
Neoadjuvant therapy | ||||||
None | 141 (22%) | 220 (21%) | 361 (22%) | 85 (26%) | 35 (20%) | 120 (23%) |
Short course (25 Gy) | 0 | 0 | 0 | 182 (56%) | 49 (28%) | 231 (47%) |
Long course (40–60 Gy) | 381 (59%) | 541 (52%) | 922 (55%) | 60 (18%) | 90 (52%) | 150 (30%) |
Chemotherapy | 305 (46%) | 455 (43%) | 760 (45%) | 232 (70%) | 129 (75%) | 361 (72%) |
NR | 125 (19%) | 283 (27%) | 398 (23%) | 0 | 0 | 0 |
Type of resection | ||||||
APR | 460 (71%) | 749 (73%) | 1209 (72%) | 3 (1%) | 47 (27%) | 50 (9%) |
ELAPE | 97 (15%) | 67 (6%) | 164 (10%) | 324 (99%) | 127 (73%) | 451 (91%) |
Pelvic exenteration | 90 (14%) | 216 (21%) | 306 (18%) | 0 | 0 | 0 |
NR | 0 | 0 | 0 | 0 | 0 | 0 |
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Buscail, E.; Canivet, C.; Shourick, J.; Chantalat, E.; Carrere, N.; Duffas, J.-P.; Philis, A.; Berard, E.; Buscail, L.; Ghouti, L.; et al. Perineal Wound Closure Following Abdominoperineal Resection and Pelvic Exenteration for Cancer: A Systematic Review and Meta-Analysis. Cancers 2021, 13, 721. https://doi.org/10.3390/cancers13040721
Buscail E, Canivet C, Shourick J, Chantalat E, Carrere N, Duffas J-P, Philis A, Berard E, Buscail L, Ghouti L, et al. Perineal Wound Closure Following Abdominoperineal Resection and Pelvic Exenteration for Cancer: A Systematic Review and Meta-Analysis. Cancers. 2021; 13(4):721. https://doi.org/10.3390/cancers13040721
Chicago/Turabian StyleBuscail, Etienne, Cindy Canivet, Jason Shourick, Elodie Chantalat, Nicolas Carrere, Jean-Pierre Duffas, Antoine Philis, Emilie Berard, Louis Buscail, Laurent Ghouti, and et al. 2021. "Perineal Wound Closure Following Abdominoperineal Resection and Pelvic Exenteration for Cancer: A Systematic Review and Meta-Analysis" Cancers 13, no. 4: 721. https://doi.org/10.3390/cancers13040721