The value of pelvic peritoneal reconstruction during abdominoperineal resection for rectal cancer: A systematic review and meta-analysis.

Abstract

<h4>Background</h4>To systematically evaluate the significance of pelvic peritoneal reconstruction during abdominoperineal resection for rectal cancer, specifically focusing on its impact on the incidence of postoperative complications, in order to provide recommendations for clinical medical practice.<h4>Methods</h4>We performed a thorough literature search using multiple databases, including PubMed, Web of Science (which includes MEDLINE), the Chinese National Knowledge Infrastructure database, and the Wan-Fang database. The search was updated until May 20, 2023, and included articles published from the earliest available dates. The selected literature was assessed for quality, and data extraction was conducted. The extracted data were then subjected to meta-analysis using RevMan 5.4 software.<h4>Results</h4>A total of 16 cohort studies were included, with publication dates ranging from 2012 to 2021, including 9 prospective cohort studies and 7 retrospective cohort studies. These studies consisted of both a pelvic peritoneal closure (PPC) group and a non-closure group. The meta-analysis revealed that patients in the PPC group had significantly lower incidence rates of the following postoperative complications compared to the non-PPC group, with statistical significance observed (P < .05): intestinal obstruction (odds ratio [OR] = 0.22, 95% confidence intervals [CI]: 0.14-0.36, P < .01), surgical site infection (OR = 0.36, 95% CI: 0.24-0.55, P < .01), pelvic and abdominal cavity infection (OR = 0.20, 95% CI: 0.05-0.79, P < .05), pelvic and abdominal cavity infection (OR = 0.17, 95% CI: 0.07-0.39, P < .01).<h4>Conclusion</h4>Our findings indicate that pelvic peritoneal reconstruction during the surgical procedure holds promise in reducing the occurrence of adverse postoperative events and may have substantial clinical implications for the management of rectal cancer.