title: Systematic review and meta-analysis of rectal washout on risk of local recurrence for cancer.
abstract: BACKGROUND
  It has been shown that intraluminal washout (WO) can prevent local recurrence (LR) of rectal cancer. This meta-analysis was to evaluate the association of rectal WO and the risk of LR after anterior resection in patients with rectal cancer.
  
  
  METHODS
  The relevant studies were identified by a search of the MEDLINE, Embase, Wiley Online Library, and Cochrane Oral Health Group Specialized Register with no restrictions on October 18, 2013, and these studies were included in a systematic review and meta-analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in fixed effects model.
  
  
  RESULTS
  A total of nine studies were included in our study, yielding a total of 5519 patients, and pooled ORs for overall LR in corresponding subgroups were calculated. Rectal WO was associated with a lower risk for LR (240/4176, 5.75% versus 9.75%, 131/1343, OR = 0.53, 95% CI = 0.42-0.68, and P < 0.00001) in patients with anterior resection, having total mesorectal excisions (234/3942, 5.93% versus 9.34%, 97/1039, OR = 0.59, 95% CI = 0.46-0.75, and P < 0.00001), and after radical resection (RR; 122/2665, 4.99% versus 8.90%, 74/831, OR = 0.56, 95% CI = 0.41-0.78, and P = 0.0005), with an overall LR rate of 6.72% (371/5519). But, the stability of RRs is not high in the total mesorectal excisions or RR subgroup by sensitivity analysis.
  
  
  CONCLUSIONS
  The use of rectal WO decreases risks of LR in patients after anterior resection of cancer.
authors.affiliation: Department of Translational Medicine Center, the First Affiliated Hospital, School of Medicine of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China; Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine of of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
authors.forename: Can
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine of of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Department of Translational Medicine Center, the First Affiliated Hospital, School of Medicine of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine of of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine of of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Translational Medicine Center, the First Affiliated Hospital, School of Medicine of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China. Electronic address: peijun1020@163.com.
authors.forename: Peijun
authors.initials: P
authors.lastname: Liu
mesh_terms: D002277:Carcinoma / Q000517:prevention & control* / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D017594:Publication Bias; D012004:Rectal Neoplasms / Q000517:prevention & control* / Q000601:surgery*; D012307:Risk Factors
keywords: Irrigation volume; Local recurrence; Meta-analysis; Normal saline; Rectal cancer