title: Rectal washout and local recurrence in rectal resection for cancer: a meta-analysis.
abstract: OBJECTIVE
  The effectiveness of rectal washout was compared with no washout for the prevention of local recurrence after anterior rectal resection for rectal cancer.
  
  
  METHODS
  The following electronic databases were searched: PubMed, OVID Medline, Cochrane Database of Systematic Reviews, EBM Reviews, CINAHL and EMBASE.
  
  
  RESULTS
  Five nonrandomized studies including a total of 5012 patients were identified. Meta-analysis suggested that rectal washout significantly reduced the local recurrence rate (P < 0.0001; OR 0.57; 95% CI 0.43-0.74). It was also significantly lower after washout in patients having radical resection only (P = 0.0004; OR 0.54; 95% CI 0.39-0.76), patients treated by a curative resection (P < 0.0001; OR 0.55; 95% CI 0.42-0.72) and those undergoing preoperative radiotherapy (P = 0.04; OR 0.62; 95% CI 0.39-0.98).
  
  
  CONCLUSIONS
  Taking into account the limitations of the design of the included studies the meta-analysis showed that rectal washout is associated with reduced local recurrence and therefore should be routine during anterior resection for rectal cancer.
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Rondelli
authors.forename: S
authors.initials: S
authors.lastname: Trastulli
authors.forename: R
authors.initials: R
authors.lastname: Cirocchi
authors.forename: N
authors.initials: N
authors.lastname: Avenia
authors.forename: E
authors.initials: E
authors.lastname: Mariani
authors.forename: F
authors.initials: F
authors.lastname: Sciannameo
authors.forename: G
authors.initials: G
authors.lastname: Noya
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D016017:Odds Ratio; D012004:Rectal Neoplasms / Q000601:surgery*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome