AIMS: To evaluate comparative outcomes of straight (end-to-end) anastomosis versus colonic J-pouch anastomosis following anterior resection. METHODS: A systematic search of multiple electronic data sources was conducted, and all studies comparing straight (end-to-end) anastomosis versus J-pouch anastomosis were included. Anastomotic complications, post-operative complications, re-operation, mortality, and functional outcomes were the evaluated outcome parameters. Revman 5.3 was used for data analysis. RESULTS: Twenty-seven studies reporting a total number of 3293 patients who underwent straight anastomosis (n = 1581) or J-pouch (n = 1712) were included. Anastomotic leak and re-operation rates were significantly higher in the straight group compared to the J-pouch group [RD 0.03, P = 0.03] and [OR 1.87, P = 0.003], respectively. Stool frequency per 24 h at 6 months and 12 months was lower in the J-pouch group than the straight group [MD 2.13, P = 0.003] and [MD 1.44, P = 0.00001], respectively. In addition, the use of anti-diarrheal medication is lower at 12 months in the J-pouch group [MD 3.85, P = 0.03]. Moreover, the two groups showed comparable results regarding SSI, sepsis, paralytic ileus, anastomotic stricture formation, anastomotic bleeding, and mortality. CONCLUSION: J-pouch anastomosis showed lower risk for anastomotic leak and re-operation. Furthermore, better functional outcomes such as stool frequency were achieved using the colonic J-pouch reconstruction over the conventional straight end-to-end anastomosis.
AIMS: To evaluate comparative outcomes of straight (end-to-end) anastomosis versus colonic J-pouch anastomosis following anterior resection. METHODS: A systematic search of multiple electronic data sources was conducted, and all studies comparing straight (end-to-end) anastomosis versus J-pouch anastomosis were included. Anastomotic complications, post-operative complications, re-operation, mortality, and functional outcomes were the evaluated outcome parameters. Revman 5.3 was used for data analysis. RESULTS: Twenty-seven studies reporting a total number of 3293 patients who underwent straight anastomosis (n = 1581) or J-pouch (n = 1712) were included. Anastomotic leak and re-operation rates were significantly higher in the straight group compared to the J-pouch group [RD 0.03, P = 0.03] and [OR 1.87, P = 0.003], respectively. Stool frequency per 24 h at 6 months and 12 months was lower in the J-pouch group than the straight group [MD 2.13, P = 0.003] and [MD 1.44, P = 0.00001], respectively. In addition, the use of anti-diarrheal medication is lower at 12 months in the J-pouch group [MD 3.85, P = 0.03]. Moreover, the two groups showed comparable results regarding SSI, sepsis, paralytic ileus, anastomotic stricture formation, anastomotic bleeding, and mortality. CONCLUSION: J-pouch anastomosis showed lower risk for anastomotic leak and re-operation. Furthermore, better functional outcomes such as stool frequency were achieved using the colonic J-pouch reconstruction over the conventional straight end-to-end anastomosis.
Authors: Alexander D Croese; James M Lonie; Alexandra F Trollope; Venkat N Vangaveti; Yik-Hong Ho Journal: Int J Surg Date: 2018-06-22 Impact factor: 6.071
Authors: Rafael Cardoso; Feng Guo; Thomas Heisser; Monika Hackl; Petra Ihle; Harlinde De Schutter; Nancy Van Damme; Zdravka Valerianova; Trajan Atanasov; Ondřej Májek; Jan Mužík; Mef Christina Nilbert; Anne Julie Tybjerg; Kaire Innos; Margit Mägi; Nea Malila; Anne-Marie Bouvier; Véronique Bouvier; Guy Launoy; Anne-Sophie Woronoff; Mélanie Cariou; Michel Robaszkiewicz; Patricia Delafosse; Florence Poncet; Alexander Katalinic; Paul M Walsh; Carlo Senore; Stefano Rosso; Ieva Vincerževskienė; Valery E P P Lemmens; Marloes A G Elferink; Tom Børge Johannesen; Hartwig Kørner; Frank Pfeffer; Maria José Bento; Jessica Rodrigues; Filipa Alves da Costa; Ana Miranda; Vesna Zadnik; Tina Žagar; Arantza Lopez de Munain Marques; Rafael Marcos-Gragera; Montse Puigdemont; Jaume Galceran; Marià Carulla; María-Dolores Chirlaque; Monica Ballesta; Kristina Sundquist; Jan Sundquist; Marco Weber; Andrea Jordan; Christian Herrmann; Mohsen Mousavi; Anton Ryzhov; Michael Hoffmeister; Hermann Brenner Journal: Lancet Oncol Date: 2021-05-25 Impact factor: 54.433
Authors: Liliana Bordeianou; Lillias Holmes Maguire; Karim Alavi; Ranjan Sudan; Paul E Wise; Andreas M Kaiser Journal: J Gastrointest Surg Date: 2014-05-13 Impact factor: 3.452