A systematic review and meta‐analysis comparing adverse events and functional outcomes of different pouch designs after restorative proctocolectomy

Simillis, Constantinos; Afxentiou, Thalia; Pellino, Gianluca; Kontovounisios, Christos; Faiz, Omar; Tekkis, Paris

doi:10.1111/codi.14104

Cited by 33 publications

(24 citation statements)

References 64 publications

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“…VOLUME 20 8 August 2018 © 2018 The Association of Coloproctology of Great Britain and Ireland. Colorectal Disease, 20, 657-746 735 Laparoscopic repair of left paraduodenal hernia -a video vignette M. S. Bodur, R. Yildirim, S. Turkyilmaz, A. Guner 736 Emergency laparoscopic colectomy for perforated diverticulitis -a video vignette T. Acar, N. Acar, F. Güngör, O. Nuri Dilek, pouch-related septic complications in ulcerative colitis: a systematic review G. H. T. Worley, J. P. Segal, J. Warusavitarne, S. K. Clark, O. D. Faiz O190 Nonsteroidal anti-infl ammatory drugs reduce the time to recovery of gut function after elective colorectal surgery: systematic review and meta-analysis T. G. E. Milne, R. Jaung, G. O'Grady, I. P. Bissett Original Articles Neoplasia O199 A statistical tool for risk assessment as a function of the number of lymph nodes retrieved from rectal cancer patients Z. Wu, G. Qin, N. Zhao, H. Jia, X. ZhengEditor's choiceA systematic review and meta-analysis comparing adverse events and functional outcomes of different pouch designs after restorative proctocolectomy by Simillis et al1 …”

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Review of current practice and outcomes following ileoanal pouch surgery: lessons learned from the Ileoanal Pouch Registry and the 2017 Ileoanal Pouch Report

et al. 2018

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confidence: 99%

Review of current practice and outcomes following ileoanal pouch surgery: lessons learned from the Ileoanal Pouch Registry and the 2017 Ileoanal Pouch Report

et al. 2018

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“…Surgical complications, failure rate and mortality are similar when the different pouch designs are compared [112]. Even though J-pouches are easier and faster to perform, they are characterized by a higher number of bowel movements than W-pouches because of the intrinsic lower volume [113]. However, a randomized trial comparing J-with W-pouches found that the difference disappeared after 6 months of follow-up [114].…”

Section: Item 13 Due To the Simple Construction Technique And The Recognized Long-term Functional Outcomes The J-pouch Is The Standard Ofmentioning

confidence: 99%

Inflammatory bowel disease position statement of the Italian Society of Colorectal Surgery (SICCR): ulcerative colitis

et al. 2020

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The Italian Society of Colorectal Surgery (SICCR) promoted the project reported here, which consists of a Position Statement of Italian colorectal surgeons to address the surgical aspects of ulcerative colitis management. Members of the society were invited to express their opinions on several items proposed by the writing committee, based on evidence available in the literature. The results are presented, focusing on relevant points. The present paper is not an alternative to available guidelines; rather, it offers a snapshot of the attitudes of SICCR surgeons about the surgical treatment of ulcerative colitis. The committee was able to identify some points of major disagreement and suggested strategies to improve the quality of available data and acceptance of guidelines.

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“…The J-shape pouch is the most frequently performed pouch because it is simple and associated with excellent long-term functional outcomes (8,20,27). No differences between the different pouch designs were observed regarding the small-bowel obstruction, anastomotic leakage, and pelvic sepsis and wound infection rates (27,28). In the present series, a J pouch was performed 93.5% of the patients.…”

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confidence: 64%

Technical Issues and Early Outcomes of Restorative Proctocolectomy for Familial Adenomatous Polyposis and Ulcerative Colitis: The Largest Romanian Single-Team Experience

Dumitraşcu¹,

Stroescu²,

Tomulescu³

et al. 2019

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RezumatIntroducere: Proctocolectomia totală restaurativă este un procedeu chirurgical complex folosit în cazul pacienţilor diagnosticaţi cu polipoză adenomatoasă familială şi rectocolită ulcero-hemoragică. Studiul de faţă îşi propune să analizeze elemente de tehnică chirurgicală, precum şi rezultatele postoperatorii imediate după proctocolectomia totală restaurativă, pe baza experienţei acumulate de către o singură echipă chirurgicală. Pacienţi şi Metodă: Datele tuturor pacienţilor cu proctocolectomia totală restaurativă efectuate de către o singură echipă chirurgicală în perioada 1991 -2018 au fost analizate retrospectiv, având în vedere existenţa unei baze de date cu intervenţii chirurgicale introduse prospectiv. Rezultate: Au fost incluşi în studiu un număr de 77 de pacienţi cu proctocolectomie totală restaurativă, dintre care 70,1% au avut diagnosticul de polipoză adenomatoasă familială. Numărul mediu anual de proctocolectomii totale restaurative a fost de 3,3 pentru echipa chirurgicală inclusă în studiu, şi 4,3 la nivel instituţional. Un rezervor de tip J a fost realizat la 93,5% dintre pacienţi; în 76,6% din cazuri rezervorul a fost realizat printr-o sutură manuală. Anastomoza ileo-anală a fost realizată printr-o sutură manuală în 81,8% dintre pacienţi. Ileostomia de protecţie s-a realizat la 92,2% dintre pacienţi iar mucosectomia la 84,4% dintre pacienţi. Complicaţii postoperatorii precoce au fost înregistrate în 36,4% dintre pacienţi, iar rata complicaţiilor severe a fost de 13%. Principalele complicaţii au fost reprezentate de complicaţiile septice având drept sursă rezervorul ileal sau anastomoza ileo-anală (18,2%), infecţiile de plagă (9,1%), ocluzia intestinală (6,5%) şi hemoragia (6,5%). Concluzii: Deşi proctocolectomia totală restaurativă rămâne un procedeu rareori practicat în România, totuşi, rezultatele postoperatorii imediate ale seriei noastre de pacienţi sunt comparabile cu cele întâlnite în centrele cu volum mare din lume. Aceste rezultate bune ale proctocolectomiei totale restaurative sunt consecinţa faptului că aceste proceduri au fost efectuate de către o echipă chirurgicala special antrenată, cu un volum mare de proceduri efectuate.Cuvinte cheie: proctocolectomie totală restaurativă, polipoză adenomatoasă familială, rectocolită ulcero-hemoragică, rezervor ileal, rezultate Abstract Background/ Aim: Restorative proctocolectomy (RPC) is a complex surgical procedure used to treat patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP). The present study aims to assess the technical issues and early outcomes of RPC for FAP and UC, in a relatively large single-team series of patients. Patients and Methods: The data of all patients with RPC performed by a single surgical team between 1991 and 2018 were retrospectively assessed from a prospectively maintained electronic database. Results: The study group included 77 patients with RPC, and 70.1% have had FAP. The average number of RPC per year was 3.3 for the surgical team and 4.3 for the institution. A J pouch was performed...

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A systematic review and meta‐analysis comparing adverse events and functional outcomes of different pouch designs after restorative proctocolectomy

Abstract: Despite its ease of construction and comparable complication rates, the J pouch is associated with higher pouch failure rates and worse function. Patient characteristics, technical factors and surgical expertise should be considered when choosing pouch design.

Cited by 33 publications

References 64 publications

Review of current practice and outcomes following ileoanal pouch surgery: lessons learned from the Ileoanal Pouch Registry and the 2017 Ileoanal Pouch Report

Review of current practice and outcomes following ileoanal pouch surgery: lessons learned from the Ileoanal Pouch Registry and the 2017 Ileoanal Pouch Report

Inflammatory bowel disease position statement of the Italian Society of Colorectal Surgery (SICCR): ulcerative colitis

Technical Issues and Early Outcomes of Restorative Proctocolectomy for Familial Adenomatous Polyposis and Ulcerative Colitis: The Largest Romanian Single-Team Experience

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