Does Intraperitoneal Chemotherapy Increase the Incidence of Anastomotic Leakage after Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis

PURPOSE: To identify and evaluate the influence of intraperitoneal chemotherapy without hyperthermia (IC(wh)) to the incidence of anastomotic leakage (AL) after colorectal cancer surgery. METHODS: A systematic review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses in order to review all studies investigating the relationship between IC(wh) and AL in patients undergoing colorectal surgery. The primary outcome was overall incidence rate of anastomotic leakage. RESULTS: Four studies were included in the final review. IC(wh) was associated with an overall increased risk of anastomotic leakage [OR 2.05 (1.06, 3.98), P = 0.03]. But there was no significant increased incidence rate when fluorouracil was implanted into the abdominal cavity for IC(wh) [OR 2.48 (0.55, 11.10), P = 0.24]. CONCLUSIONS: This meta-analysis provides some evidence to suggest IC(wh) may increase the incidence of postoperative AL in colorectal cancer. However, fluorouracil implantation for IC(wh) does not increase the risk of AL, which seems to be a relatively safe method of IC(wh).