Inadvertent Laparoscopic Lavage of Perforated Colon Cancer: A Systematic Review

Authors

Mahir Gachabayov, Department of Surgery, Jacobi Medical Center, New York City Health Hospitals, Building 1, Suite 610, 1400 Pelham Parkway S, New York, NY, USA.
Agon Kajmolli, Department of Surgery, Jacobi Medical Center, New York City Health Hospitals, Building 1, Suite 610, 1400 Pelham Parkway S, New York, NY, USA.
Luis Quintero, Department of Surgery, Jacobi Medical Center, New York City Health Hospitals, Building 1, Suite 610, 1400 Pelham Parkway S, New York, NY, USA.
Daniel M. Felsenreich, Division of Visceral Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
Dorin E. Popa, Department of General Surgery, Linköping University Hospital, Linköping, Sweden.
Dejan Ignjatovic, Department of Digestive Surgery, Akershus University Hospital, University of Oslo, Lorenskog, Norway.
Roberto Bergamaschi, Department of Surgery, Jacobi Medical Center, New York City Health Hospitals, Building 1, Suite 610, 1400 Pelham Parkway S, New York, NY, USA. rcmbergamaschi@gmail.com.

Author Type(s)

Resident/Fellow, Faculty

Journal Title

Langenbeck's Archives of Surgery

First Page

35

Document Type

Article

Publication Date

1-10-2024

Department

Surgery

Abstract

BACKGROUND: Although laparoscopic lavage for perforated diverticulitis with peritonitis has been grabbing the headlines, it is known that the clinical presentation of peritonitis can also be caused by an underlying perforated carcinoma. The aim of this study was to determine the incidence of patients undergoing inadvertent laparoscopic lavage of perforated colon cancer as well as the delay in cancer diagnosis. 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 endpoints of this meta-analysis were the rates of perforated colon cancer patients having undergone inadvertent laparoscopic lavage as well as the delay in cancer diagnosis. This was expressed in pooled rate % and 95% confidence intervals. RESULTS: Eleven studies (three randomized, two prospective, six retrospective) totaling 642 patients met inclusion criteria. Eight 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 (Isquare2 = 34.02%) in eight studies. Cancer rates were 8.2% (0%, 3%) (Isquare2 = 58.2%) and 1.7% (0%, 4.5%) (Isquare2 = 0%) in prospective and retrospective studies, respectively. Randomized trials reported a cancer rate of 7.2% (3.1%, 11.2%) with low among-study heterogeneity (Isquare2 = 0%) and a median delay to diagnosis of 2 (1.5-5) months. CONCLUSIONS: This systematic review found that 7% of patients undergoing laparoscopic lavage for peritonitis had perforated colon cancer with a delay to diagnosis of up to 5 months.

Recommended Citation

Gachabayov, M., Kajmolli, A., Quintero, L., Felsenreich, D. M., Popa, D. E., Ignjatovic, D., & Bergamaschi, R. (2024). Inadvertent Laparoscopic Lavage of Perforated Colon Cancer: A Systematic Review. Langenbeck's Archives of Surgery, 409 (1), 35. https://doi.org/10.1007/s00423-023-03224-5