Efficacy of pelvic floor peritoneal reconstruction after laparoscopic resection of middle and low rectal cancer: A meta-analysis

Figure 2 Forest plot. A: Comparing the risk of postoperative intestinal obstruction between the reconstruction and control groups. The pooled association was relative risk (RR) = 0.30 (95%CI: 0.18-0.49, P_effect < 0.001), with I² = 0% and P_{heterogeneity} = 0.52. A fixed-effect model was used; B: Comparing the risk of postoperative intestinal obstruction following laparoscopic abdominoperineal resection (LAPR) between the reconstruction and control groups. For LAPR/extralevator abdominoperineal excision (ELAPE), the pooled association was RR = 0.25 (95%CI: 0.12-0.52; P_effect < 0.001), with I² = 0% and P_{heterogeneity} = 0.85; a fixed-effect model was used; C: Comparing the risk of postoperative intestinal obstruction following laparoscopic anterior rectal resection (LAR) between the reconstruction and control groups. For LAR, the pooled association was RR = 0.34 (95%CI: 0.17-0.70; P_effect = 0.003) with I² = 32% and P_{heterogeneity} = 0.21; a fixed-effect model was used; D: Comparing the risk of postoperative internal hernia between the reconstruction and control groups. The pooled association was RR = 0.36 (95%CI: 0.17-0.79; P_effect = 0.010), with I² = 0% and P_{heterogeneity} = 0.52; a fixed-effect model was used; E: Comparing the risk of postoperative anastomotic leak between the reconstruction and control groups. The pooled association was RR = 0.69 (95%CI: 0.51-0.93; P_effect = 0.020), with I² = 5% and P_{heterogeneity} = 0.64; a fixed-effect model was used; F: Comparing the risk of postoperative unplanned reoperations between the reconstruction and control groups. The pooled association was RR = 0.33 (95%CI: 0.19-0.57; P_effect < 0.001), with I² = 0% and P_{heterogeneity} = 0.52; a fixed-effect model was used; G: Comparing the risk of unplanned reoperations following LAPR between the reconstruction and control groups. For LAPR/ELAPE, the pooled association was RR = 0.40 (95%CI: 0.16-0.98; P_effect = 0.046), with I² = 38% and P_{heterogeneity} = 0.20; a fixed-effect model was used; H: Comparing the risk of unplanned reoperations following LAR between the reconstruction and control groups. For LAR, the pooled association was RR = 0.30 (95%CI: 0.15-0.60; P_effect < 0.001), with I² = 0% and P_{heterogeneity} = 0.78; a fixed-effect model was used; I: Comparing postoperative length of hospital stay between the reconstruction and control groups. The random-effects estimate was MD = -2.40 days (95%CI: -4.33 to -0.47; P_effect = 0.015), with I² = 87% and P_{heterogeneity} < 0.001. The results were unstable in leave-one-out sensitivity analyses. PC: Pelvic floor peritoneal reconstruction.