title: Does Preoperative Radio(chemo)therapy Increase Anastomotic Leakage in Rectal Cancer Surgery? A Meta-Analysis of Randomized Controlled Trials.
abstract: Objective. Preoperative radio(chemo)therapy (pR(C)T) appears to increase postoperative complications of rectal cancer resection, but clinical trials have reported conflicting results. The objective of this meta-analysis was performed to assess the effects of pR(C)T on anastomotic leak after rectal cancer resection. Methods. PubMed, Embase, and the Cochrane Library were searched from January 1980 to January 2014. Randomized controlled trials included all original articles reporting anastomotic leak in patients with rectal cancer, among whom some received preoperative radiotherapy or chemoradiotherapy while others did not. The analysed end-points were the anastomotic leak. Result. Seven randomized controlled trials with 3375 patients were included in the meta-analysis. 1660 forming the group undergoing preoperative radiotherapy or chemoradiotherapy versus 1715 patients undergoing without preoperative radiotherapy or chemoradiotherapy. The meta-analyses found that pR(C)T was not an independent risk factor for anastomotic leakage (OR 1.02, 95% CI 0.80-1.30; P = 0.88). Subgroups analysis was performed and the result was not altered. Conclusions. Current evidence demonstrates that pR(C)T did not increase the risk of postoperative anastomotic leak after rectal cancer resection in patients.
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan Second Road, Guangzhou, Guangdong 510080, China ; Department of Gastrointestinal Surgery, Huai He Hospital of Henan University, Kaifeng, China.
authors.forename: Changjiang
authors.initials: C
authors.lastname: Qin
authors.affiliation: Department of Gastrointestinal Surgery, Huai He Hospital of Henan University, Kaifeng, China.
authors.forename: Xuequn
authors.initials: X
authors.lastname: Ren
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan Second Road, Guangzhou, Guangdong 510080, China.
authors.forename: Kaiwu
authors.initials: K
authors.lastname: Xu
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan Second Road, Guangzhou, Guangdong 510080, China.
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan Second Road, Guangzhou, Guangdong 510080, China.
authors.forename: Yulong
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan Second Road, Guangzhou, Guangdong 510080, China.
authors.forename: Xinming
authors.initials: X
authors.lastname: Song