Evidence map›Paper›PMID 40180681›Full record

SynthesisInternational journal of colorectal disease2025

Short- and long-term outcomes of minimally invasive vs. open pelvic exenteration in rectal tumours: a focused meta-analysis.

Yu-Jen Hsu, Zhen-Hao Yu, Bor-Kang Jong, Jeng-Fu You, Yen-Lin Yu, Chun-Kai Liao, Cheng-Chou Lai, Yih-Jong Chern

Registry-linked trialAbstract readMeta-AnalysisSystematic ReviewComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07395505 (From Cure to Quality), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07395505 enrolling by invitationnot on this map

From Cure to Quality: Advancing Surgical and Postoperative Outcomes in Pelvic Exenteration

Typeobservational_patient_registrySponsorChang Gung Memorial HospitalRan2025 to 2029Enrolled24ConditionsRectal Cancer Recurrent, Pelvic Exenteration, Advanced Rectal Cancer
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yu-Jen HsuDivision of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fu-Hsing St., Kuei-Shan, Taoyuan, 33305, Taiwan.ORCID http://orcid.org/0000-0002-3068-8999
Zhen-Hao YuDivision of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fu-Hsing St., Kuei-Shan, Taoyuan, 33305, Taiwan.
Bor-Kang JongDivision of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fu-Hsing St., Kuei-Shan, Taoyuan, 33305, Taiwan.
Jeng-Fu YouDivision of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fu-Hsing St., Kuei-Shan, Taoyuan, 33305, Taiwan.ORCID http://orcid.org/0000-0001-5748-1659
Yen-Lin YuCollege of Medicine, Chang Gung University, No. 259, Wenhua 1St Rd., Guishan Dist., Taoyuan City, 333323, Taiwan.ORCID http://orcid.org/0000-0003-3909-1715
Chun-Kai LiaoDivision of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fu-Hsing St., Kuei-Shan, Taoyuan, 33305, Taiwan.ORCID http://orcid.org/0000-0002-7497-4444
Cheng-Chou Lai *Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fu-Hsing St., Kuei-Shan, Taoyuan, 33305, Taiwan. lai55562014@gmail.com.
Yih-Jong Chern *Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fu-Hsing St., Kuei-Shan, Taoyuan, 33305, Taiwan. ufo789.ufo789@gmail.com.ORCID http://orcid.org/0000-0002-7572-4930

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePelvic exenteration (PE) is a complex surgical procedure used to treat patients with recurrent or locally advanced rectal cancer (LARC) as a final recourse. Thus, minimally invasive surgery (MIS) has emerged as an alternative to the traditional open PE as it may reduce surgical trauma and improve recovery. This meta-analysis compared the clinical outcomes between MIS and open PE in patients with LARC.

methodsA systematic review and meta-analysis were conducted following PRISMA and AMSTAR guidelines. Six retrospective studies comprising 368 patients (179 MIS patients; 189 open patients) were included. Data on operative parameters along with short-term and long-term outcomes, including the 3-year overall (OS) and disease-free survival (DFS), were extracted. Risk ratios (RRs) and odds ratios (ORs) were calculated for binary outcomes, while standardised mean differences (SMDs) were calculated for continuous outcomes. All measures were reported with 95% confidence intervals (CIs) using random-effects models.

resultsMIS was associated with significantly reduced blood loss (standardised mean difference (SMD), - 1.57; 95% CI, - 2.27 to - 0.88; p < 0.00001), shorter hospital stays (SMD, - 6.46; 95% CI, - 12.21 to - 0.71; p = 0.03), and quicker diet resumption (SMD: - 0.79; 95% CI, - 1.36 to - 0.21; p = 0.008) than open PE. MIS was associated with a borderline reduction in total complications (OR, 0.45; 95% CI, 0.20-1.00; p = 0.05) and lower rates of abdominal wound complications (OR, 0.22; 95% CI, 0.11 to 0.45; p < 0.0001). No significant differences were observed in R0 resection rates, major complications, or mortality. For long-term outcomes, MIS demonstrated significantly improved 3-year OS (RR, 1.19; 95% CI, 1.01 to 1.41; p = 0.04), whereas 3-year DFS showed no significant difference (RR, 1.02; 95% CI, 0.79 to 1.41; p = 0.87).

conclusionMIS offers significant short-term advantages over open PE, including reduced blood loss, faster recovery, and fewer complications while demonstrating improved 3-year OS. These findings support MIS PE as a safe, effective, and viable option for patients with recurrent or LARC.

Indexed as

Minimally Invasive Surgical ProceduresPelvic ExenterationRectal NeoplasmsBlood Loss, SurgicalDisease-Free SurvivalHumansLength of StayPostoperative ComplicationsPublication BiasTime FactorsTreatment OutcomeMinimally invasive surgeryOutcomePelvic exenterationRectal cancer

Identifiers

PMID40180681
PMCPMC11968480

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.