Acceptance of a 5‐mm distal bowel resection margin for rectal cancer: is it safe?

Rutkowski, A.; Nowacki, Marek P.; Chwaliński, Maciej; Olędzki, Janusz; Bednarczyk, M.; Liszka-Dalecki, Piotr; Gornicki, A.; Bujko, Krzysztof

doi:10.1111/j.1463-1318.2010.02542.x

Cited by 42 publications

(40 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The remaining 17 studies constituted the material for the current review. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Only one report prospectively explored the issue in question as the secondary end point. 20 The remaining reports were retrospective.…”

Section: Resultsmentioning

confidence: 99%

“…In case of a lack of relevant information in the reports published by our group, information was extracted from the original databases. 5,9,20,23 In cases requiring additional clarification, the authors of the reports were contacted.…”

Section: Methodsmentioning

confidence: 99%

“…In the remaining 15 studies the difference in local recurrence rate between the short margin group and to the long margin group was not significant in univariate analysis. [7][8][9][10][11][12][13][15][16][17][19][20][21][22][23] Of the eight reports showing long-term survival, survival did not differ statistically between the two groups in seven; in one remaining study survival was lower in the short margin group compared to the long margin group ( Table 1).…”

Section: Outcomes In Relation To Distal Bowel Margin Shorter or Longementioning

confidence: 99%

“…Four remaining series showed no association between the length of bowel clearance and anastomotic recurrence. 9,11,15,21 This was confirmed by multivariable analysis carried out in the largest series reported by Kim et al 21 The results of the meta-analysis methodology used to evaluate all of the above reports showed that the estimated overall anastomotic recurrence rate was 1.6% higher in the \1-cm margin group compared to the [1-cm margin group (95% CI -0.8 to 4.1) but this was not statistically significant (P = 0.221); test for heterogeneity, P = 0.97.…”

Section: Anastomotic Recurrences In Relation To Distal Bowel Margin Smentioning

confidence: 99%

“…Here the clinical evidence is less clear regarding what constitutes an adequate distal margin, particularly in the setting of neoadjuvant chemoradiotherapy. [7][8][9] Therefore, the purpose of this study was to perform a systematic review of the impact of distal rectal margins of less than approximately 1 cm on oncologic outcomes after sphincter-preserving surgery for rectal cancer.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Is the 1-cm Rule of Distal Bowel Resection Margin in Rectal Cancer Based on Clinical Evidence? A Systematic Review

Bujko

Rutkowski

Chang

et al. 2012

Indian J Surg Oncol

View full text Add to dashboard Cite

Background. Distal intramural spread is present within 1 cm from visible tumor in a substantial proportion of patients. Therefore, C1 cm of distal bowel clearance is recommended as minimally acceptable. However, clinical results are contradictory in answering the question of whether this rule is valid. The aim of this review was to evaluate whether in patients undergoing anterior resection, a distal bowel gross margin of \1 cm jeopardizes oncologic safety. Methods. A systematic review of the literature identified 17 studies showing results in relation to margins of approximately \1 cm (948 patients) versus [1 cm (4626 patients); five studies in relation to a margin of B5 mm (173 patients) versus [5 mm (1277 patients), and five studies showing results in a margin of B2 mm (73 patients). In most studies, pre-or postoperative radiation was provided. Results. A multifactorial process was identified resulting in selection of favorable tumors for anterior resection with the short bowel margin and unfavorable tumors for abdominoperineal resection or for anterior resection with the long margin. In total, the local recurrence rate was 1.0% higher in the \1-cm margin group compared to the [1-cm margin group (95% confidence interval [CI] -0.6 to 2.7; P = 0.175). The corresponding figures for B5 mm cutoff point were 1.7% (95% CI -1.9 to 5.3; P = 0.375). The pooled local recurrence rate in patients having B2 mm margin was 2.7% (95% CI 0 to 6.4). Conclusions. In the selected group of patients, \1 cm margin did not jeopardize oncologic safety.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Outcomes In Relation To Distal Bowel Margin Shorter or Longementioning

confidence: 99%

Section: Anastomotic Recurrences In Relation To Distal Bowel Margin Smentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Is the 1-cm Rule of Distal Bowel Resection Margin in Rectal Cancer Based on Clinical Evidence? A Systematic Review

Bujko

Rutkowski

Chang

et al. 2012

Indian J Surg Oncol

View full text Add to dashboard Cite

show abstract

Obese patients and robotic colorectal surgery: systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

Background: Obesity is a major health problem, demonstrated to double the risk of colorectal cancer. The benefits of robotic colorectal surgery in obese patients remain largely unknown. This meta-analysis evaluated the clinical and pathological outcomes of robotic colorectal surgery in obese and non-obese patients. Methods: MEDLINE, Embase, Global Health, Healthcare Management Information Consortium (HMIC) and Midwives Information and Resources Service (MIDIRS) databases were searched on 1 August 2018 with no language restriction. Meta-analysis was performed according to PRISMA guidelines. Obese patients (BMI 30 kg/m 2 or above) undergoing robotic colorectal cancer resections were compared with non-obese patients. Included outcome measures were: operative outcomes (duration of surgery, conversion to laparotomy, blood loss), postoperative complications, hospital length of stay and pathological outcomes (number of retrieved lymph nodes, positive circumferential resection margins and length of distal margin in rectal surgery). Results: A total of 131 full-text articles were reviewed, of which 12 met the inclusion criteria and were included in the final analysis. There were 3166 non-obese and 1420 obese patients. A longer duration of surgery was documented in obese compared with non-obese patients (weighted mean difference −21⋅99 (95 per cent c.i. −31⋅52 to −12⋅46) min; P < 0⋅001). Obese patients had a higher rate of conversion to laparotomy than non-obese patients (odds ratio 1⋅99, 95 per cent c.i. 1⋅54 to 2⋅56; P < 0⋅001). Blood loss, postoperative complications, length of hospital stay and pathological outcomes were not significantly different in obese and non-obese patients. Conclusion: Robotic surgery in obese patients results in a significantly longer duration of surgery and higher conversion rates than in non-obese patients. Further studies should focus on better stratification of the obese population with colorectal disease as candidates for robotic procedures.

show abstract

Fragmented pattern of tumor regression and lateral intramural spread may influence margin appropriateness after TEM for rectal cancer following neoadjuvant CRT

Perez

Habr‐Gama

Smith

et al. 2014

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

Acceptance of a 5‐mm distal bowel resection margin for rectal cancer: is it safe?

Abstract: A distal margin of ≤ 5 mm did not compromise oncological safety in patients undergoing preoperative radiation for an advanced rectal cancer.

Cited by 42 publications

References 22 publications

Is the 1-cm Rule of Distal Bowel Resection Margin in Rectal Cancer Based on Clinical Evidence? A Systematic Review

Is the 1-cm Rule of Distal Bowel Resection Margin in Rectal Cancer Based on Clinical Evidence? A Systematic Review

Obese patients and robotic colorectal surgery: systematic review and meta-analysis

Fragmented pattern of tumor regression and lateral intramural spread may influence margin appropriateness after TEM for rectal cancer following neoadjuvant CRT

Contact Info

Product

Resources

About