J-pouch anastomosis showed lower risk for anastomotic leak and re-operation. Moreover, the two groups showed comparable results regarding SSI, sepsis, paralytic ileus, anastomotic stricture formation, anastomotic bleeding, and mortality.
In addition, the use of anti-diarrheal medication is lower at 12 months in the J-pouch group. Stool frequency per 24 h at 6 months and 12 months was lower in the J-pouch group than the straight group and, respectively. Anastomotic leak and re-operation rates were significantly higher in the straight group compared to the J-pouch group and, respectively. Twenty-seven studies reporting a total number of 3293 patients who underwent straight anastomosis (n = 1581) or J-pouch (n = 1712) were included. Anastomotic complications, post-operative complications, re-operation, mortality, and functional outcomes were the evaluated outcome parameters. To evaluate comparative outcomes of straight (end-to-end) anastomosis versus colonic J-pouch anastomosis following anterior resection.Ī systematic search of multiple electronic data sources was conducted, and all studies comparing straight (end-to-end) anastomosis versus J-pouch anastomosis were included. However, close attention should be paid to the long-term defecation frequency after SPR. The advantages of SEA include a shorter operating time, a lower incidence of incomplete defecation at 3 months after surgery, and better sphincter function. The present evidence suggests that SEA is an effective anastomotic strategy to achieve similar postoperative bowel function without increasing the risk of complications compared with CJP anastomosis. No significant differences were observed between the groups in terms of efficacy outcomes including defecation frequency, the incidence of urgency, incomplete defecation, the use of pads, enema, medications, anorectal squeeze pressure and maximum rectal volume, or safety outcomes including operating time, blood loss, the use of protective stoma, postoperative complications, clinical outcomes, and oncological outcomes. A higher anorectal resting pressure (WMD = 6.25 95% CI, 0.17–12.32 P = 0.04) was found in the SEA group but the heterogeneity was high ( I ² = 84.5%, P = 0.84). A shorter operating time (WMD = − 17.65 95% CI, − 23.28 to − 12.02 P < 0.01) was also observed in the SEA group without significant heterogeneity ( I ² = 0%, P = 0.54). Patients undergoing SEA had a higher defecation frequency at 12 months after SPR (WMD = 0.20 95% CI, 0.14–0.26 P < 0.01) than those undergoing CJP anastomosis with low heterogeneity ( I ² = 0%, P = 0.54) and a lower incidence of incomplete defecation at 3 months after surgery (RR = 0.28 95% CI, 0.09–0.86 P = 0.03).
#Bad piggies online 2018 sea87 software#
All outcomes were calculated with 95% confidence intervals (CI) by STATA software (Stata 14, Stata Corporation, TX, USA).Ī total of 864 patients from 10 RCTs were included in the meta-analysis. The outcomes included the pooled risk ratio (RR) for dichotomous variables and weighted mean differences (WMDs) for continuous variables. The inclusion criteria were randomized controlled trials (RCTs) that evaluated the safety or efficacy of SEA in comparison with CJP anastomosis. PubMed, Embase, Web of Science, and the Cochrane Register of Controlled Trials databases were searched. The protocol was registered in PROSPERO under number CRD42020206764.
We performed a meta-analysis to compare the safety and efficacy of SEA with colonic J-pouch (CJP) anastomosis, which had been proven effective in improving postoperative bowel function. The application of side-to-end anastomosis (SEA) in sphincter-preserving resection (SPR) is controversial.
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