AI Article Synopsis
- The article reviews the effectiveness of Minimal Access Surgery (M-CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) compared to Open Cytoreductive Surgery (O-CRS) for patients with peritoneal surface malignancies, finding better peri-operative outcomes with M-CRS.
- A systematic search yielded 2,807 articles, with 14 selected for a meta-analysis, which showed significant improvements in blood loss, blood transfusion rates, bowel recovery, and hospital stay for the M-CRS group.
- While patient demographics were similar, and some survival data suggested comparable outcomes, the study concludes that M-CRS and HIPEC/EPIC present promising alternatives to traditional open
Article Abstract
Introduction: Minimal Access Surgery (MAS) has shown better peri-operative outcomes with equivalent oncological outcomes in gastrointestinal and thoracic oncology. Open CRS (O-CRS) procedure accompanies inevitable and significant surgical morbidity in patients. The aim of the review article is to compare outcomes of M-CRS and HIPEC/EPIC with open procedure in peritoneal surface malignancies.
Content: Comprehensive search of databases was done and total 2,807 articles were found (2793-PubMed and 14-Cochrane review). PRISMA flow chart was prepared and 14 articles were selected. Meta-analysis was performed according to PRISMA guidelines using random-effects model (DerSimonian Laird) and fixed effect model. Publication bias was tested with Funnel plot and Egger's regression test. Quality of studies was assessed by Newcastle-Ottawa scale.
Summary And Outlook: Patients in both groups [total (732), M-CRS(319), O-CRS(413)] were similar in demographic characteristics. Peri-operative outcomes were significantly better in M-CRS group in terms of blood loss SMD=-2.379, p<0.001 (95 % CI -2.952 to -1.805), blood transfusion RR=0.598, p=0.011 (95 % CI 0.402 to 0.889), bowel recovery SMD=-0.843, p=0.01 (95 % CI -1.487 to -0.2), hospital stay SMD=-2.348, p<0.001 (95 % CI -3.178 to -1.519) and total morbidity RR=0.538, p<0.001 (95 % CI 0.395 to 0.731). Duration of surgery SMD=-0.0643 (95 % CI -0.993 to 0.865, p=0.892) and CC0 score RR=1.064 (95 % CI 0.992 to 1.140, p=0.083) had no significant difference. Limited studies which evaluated survival showed similar outcomes. This meta-analysis shows that M-CRS and HIPEC/EPIC is feasible and has better peri-operative outcomes compared to open procedure in patients with limited peritoneal carcinoma index (PCI) peritoneal surface malignancies. Survival outcomes were not calculated. Further studies are warranted in this regard.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10980983 | PMC |
| http://dx.doi.org/10.1515/pp-2023-0017 | DOI Listing |
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