Rates of Perforated Colon Cancer Undergoing Laparoscopic Lavage

Author Type(s)

Faculty, Resident/Fellow

Document Type

Abstract

Publication Date

2022

Journal Title

Annals of Surgical Oncology

Department

Surgery

Abstract

INTRODUCTION: Although laparoscopic lavage seems to be grabbing the headlines, it is known that the clinical symptoms and signs of peritonitis can be caused by an underlying perforated carcinoma. As such, it is possible that a rate of perforated colon cancer is undergoing lavage. The aim of this study was to determine the rate of perforated colon cancer patients having undergone laparoscopic lavage for suspected perforated diverticulitis. METHODS: The PubMed database was systematically searched to include all studies meeting inclusion criteria. Studies were screened through titles and abstracts with potentially eligible studies undergoing full-text screening. The primary endpoint of this meta-analysis was the postoperative cancer rate of patients who underwent laparoscopic lavage for peritonitis secondary to assumed acute diverticulitis. RESULTS: Eleven studies (3 randomized control trials, 2 prospective, 6 retrospective) totaling 642 patients met inclusion criteria. 8 studies reported how patients were screened for cancer and the number of patients who completed follow-up. The pooled cancer rate was 3.4% (0.9%, 5.8%) with low heterogeneity (I2=34.02%) in the 8 studies. Prospective and retrospective studies had cancer rates of 8.2% (0%, 3%) (I2=58.2%) and 1.7% (0%, 4.5%) (I2=0%), respectively. The RCTs reported a cancer rate of 7.2% (3.1%, 11.2%) with low among-study heterogeneity (I2=0%). CONCLUSIONS: This meta-analysis found that up to 11% of patients undergoing laparoscopic lavage for peritonitis had perforated colon cancer rather than sigmoid diverticulitis. Study design seems a factor in the reporting of such rates, as lower rates of cancer have been reported in retrospective studies as compared to their prospective counterparts.

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