Meta-analysis of reconstruction techniques after low anterior resection for rectal cancer.
Br J Surg
; 102(7): 735-45, 2015 Jun.
Article
em En
| MEDLINE
| ID: mdl-25833333
ABSTRACT
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
/
Reto
/
Proctocolectomia Restauradora
/
Colo
/
Procedimentos de Cirurgia Plástica
Tipo de estudo:
Clinical_trials
/
Systematic_reviews
Aspecto:
Patient_preference
Limite:
Humans
Idioma:
En
Revista:
Br J Surg
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Alemanha