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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| Hauptverfasser: | , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
31 March 2015
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| In: |
The British journal of surgery
Year: 2015, Jahrgang: 102, Heft: 7, Pages: 735-745 |
| ISSN: | 1365-2168 |
| DOI: | 10.1002/bjs.9782 |
| Online-Zugang: | 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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| Verfasserangaben: | F.J. Hüttner, S. Tenckhoff, K. Jensen, L. Uhlmann, Y. Kulu, M.W. Büchler, M.K. Diener and A. Ulrich |
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| 245 | 1 | 0 | |a Meta-analysis of reconstruction techniques after low anterior resection for rectal cancer |c F.J. Hüttner, S. Tenckhoff, K. Jensen, L. Uhlmann, Y. Kulu, M.W. Büchler, M.K. Diener and A. Ulrich |
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| 520 | |a 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. | ||
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