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Meta-analysis of reconstruction techniques after low anterior resection for rectal cancer

Background Options for reconstruction after low anterior resection (LAR) for rectal cancer include straight or side-to-end coloanal anastomosis (CAA), colonic J pouch and transverse coloplasty. This systematic review compared these techniques in terms of function, surgical outcomes and quality of li...

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Main Authors: Hüttner, Felix (Author) , Tenckhoff, Solveig (Author) , Jensen, Katrin (Author) , Uhlmann, Lorenz (Author) , Kulu, Yakup (Author) , Büchler, Markus W. (Author) , Diener, Markus K. (Author) , Ulrich, Alexis (Author)
Format: Article (Journal)
Language:English
Published: 31 March 2015
In: The British journal of surgery
Year: 2015, Volume: 102, Issue: 7, Pages: 735-745
ISSN:1365-2168
DOI:10.1002/bjs.9782
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/bjs.9782
Verlag, lizenzpflichtig, Volltext: https://bjssjournals.onlinelibrary.wiley.com/doi/abs/10.1002/bjs.9782
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Author Notes:F.J. Hüttner, S. Tenckhoff, K. Jensen, L. Uhlmann, Y. Kulu, M.W. Büchler, M.K. Diener and A. Ulrich
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Summary:Background Options for reconstruction after low anterior resection (LAR) for rectal cancer include straight or side-to-end coloanal anastomosis (CAA), colonic J pouch and transverse coloplasty. This systematic review compared these techniques in terms of function, surgical outcomes and quality of life. Methods A systematic literature search (MEDLINE, Embase and the Cochrane Library, from inception of the databases until November 2014) was conducted to identify randomized clinical trials comparing reconstructive techniques after LAR. Random-effects meta-analyses were carried out, and results presented as weighted odds ratios or mean differences with corresponding 95 per cent c.i. A network meta-analysis was conducted for the outcome anastomotic leakage. Results The search yielded 965 results; 21 trials comprising data from 1636 patients were included. Colonic J pouch was associated with lower stool frequency and antidiarrhoeal medication use for up to 1 year after surgery compared with straight CAA. Transverse coloplasty and side-to-end CAA had similar functional outcomes to the colonic J pouch. No superiority was found for any of the techniques in terms of anastomotic leak rate. Conclusion Colonic J pouch and side-to-end CAA or transverse coloplasty lead to a better functional outcome than straight CAA for the first year after surgery.
Item Description:Gesehen am 03.06.2020
Physical Description:Online Resource
ISSN:1365-2168
DOI:10.1002/bjs.9782

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