Advantages and disadvantages of laparoscopic access for pelvic exenteration in patients with locally advanced rectal cancer (a meta-analysis and a systematic review)
https://doi.org/10.33878/2073-7556-2025-24-3-194-200
Abstract
AIM: pelvic exenteration is a surgical procedure for locally advanced pelvic organ cancer in order to achieve optimal resection margins. The expediency of performing such operations with laparoscopic access is controversial. A meta-analysis was done to evaluate the effectiveness of laparoscopic pelvic exenterations for rectal cancer.
MATERIALS AND METHODS: a systematic review was conducted in accordance with PRISMA practices and recommendations. Literature search was carried out in the electronic medical literature databases PubMed and eLibrary. According to a meta-analysis of 4 original studies, the results of treatment of 220 patients who underwent laparoscopic exenteration and 311 patients who underwent open surgery were evaluated.
RESULTS: significant differences were obtained in the reduction of intraoperative blood loss by 427 ml, 95% CI, p = 0.0004, and postoperative hospital stay by 2 days, 95% CI, p = 0.003 in the laparoscopic group. Comparable data were obtained for the operation time, p = 0.45, for the positive margin of resection (OR 0.85; 95% CI 0.19–3.93; p = 0.84), for the postoperative morbidity (OR 0.62; 95% CI 0.23–1.86; p = 0.34) and for surgical site infections (OR 0.56; 95% CI 0.18–1.64; p = 0.29).
CONCLUSION: laparoscopic exenterations are comparable in operation time to open procedure, reduce intraoperative blood loss and postoperative hospital stay days.
About the Authors
A. A. Balkarov
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Artyom A. Balkarov.
Salyama Adilya st., 2, 123423, Moscow
S. V. Chernyshov
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Stanislav V. Chernyshov.
Salyama Adilya st., 2, 123423, Moscow
E. G. Rybakov
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Evgeny G. Rybakov.
Salyama Adilya st., 2, 123423, Moscow
M. S. Likhter
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Mikhail S. Likhter.
Salyama Adilya st., 2, 123423, Moscow
Yu. A. Shelygin
Ryzhikh National Medical Research Center of Coloproctology; Russian Medical Academy of Continuous Postgraduate Education
Russian Federation
Russian Federation
Yuri A. Shelygin.
Salyama Adilya st., 2, 123423, Moscow; Barricadnaya st., 2/1, Moscow, 123995
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Review
For citations:
Balkarov A.A., Chernyshov S.V., Rybakov E.G., Likhter M.S., Shelygin Yu.A. Advantages and disadvantages of laparoscopic access for pelvic exenteration in patients with locally advanced rectal cancer (a meta-analysis and a systematic review). Koloproktologia. 2025;24(3):194-200. (In Russ.) https://doi.org/10.33878/2073-7556-2025-24-3-194-200
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