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

• Verfasst von: Hüttner, Felix [VerfasserIn]
• Verfasst von: Tenckhoff, Solveig [VerfasserIn]
• Verfasst von: Jensen, Katrin [VerfasserIn]
• Verfasst von: Uhlmann, Lorenz [VerfasserIn]
• Verfasst von: Kulu, Yakup [VerfasserIn]
• Verfasst von: Büchler, Markus W. [VerfasserIn]
• Verfasst von: Diener, Markus K. [VerfasserIn]
• Verfasst von: Ulrich, Alexis [VerfasserIn]
• Titel: Meta-analysis of reconstruction techniques after low anterior resection for rectal cancer
• Verf.angabe: F.J. Hüttner, S. Tenckhoff, K. Jensen, L. Uhlmann, Y. Kulu, M.W. Büchler, M.K. Diener and A. Ulrich
• E-Jahr: 2015
• Jahr: 31 March 2015
• Umfang: 11 S.
• Fussnoten: Gesehen am 03.06.2020
• Titel Quelle: Enthalten in: The British journal of surgery
• Ort Quelle: Oxford : Oxford University Press, 1913
• Jahr Quelle: 2015
• Band/Heft Quelle: 102(2015), 7, Seite 735-745
• ISSN Quelle: 1365-2168
• DOI: doi:10.1002/bjs.9782
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 169930775X

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.