780 Effectiveness of Colonic/Rectal Washout in Reducing Risk of Local Recurrence in Rectal and Distal Left Sided Colonic Cancer Resection. A Meta-Analysis

Abstract

Abstract Background Lab and clinical studies have shown evidence that local recurrence (LR) occurs due to free cancer cells at resection sites. Evidence for the effectiveness of rectal washout (RW) in washing out these cells and reducing the incidence of local recurrence in the literature is equivocal. Aims To determine whether intraoperative RW can effectively reduce the incidence of LR in rectal and distal colonic tumour resection. Method A literature search was conducted according to PRISMA guidelines. The primary endpoint was incidence of local recurrence of cancer after rectal cancer surgery. Results The meta-analysis revealed that at 5 year follow up, local recurrence in the washout group (WO) was 6.08% compared to 9.48% in the no-washout group (NWO) group (OR 0.63, 95% CI = 0.51 –0.73, Chi2 = 6.76, df = 7, p = 0.45). Based on this study we found the number needed to treat would be 29.3 (95%CI 20.9 –56.6) in order to prevent one local recurrence at 5 years. Conclusions RW reduces the risk of LR in patients with distal colorectal cancer resection in the long term follow up. A small number of patients needed to be treated to avoid one local recurrence in the five year follow up.