Meta-analysis of short-term and long-term outcomes of J, W and S ileal reservoirs for restorative proctocolectomy

R. E. Lovegrove, A. G. Heriot, V. Constantinides, H. S. Tilney, A. W. Darzi, V. W. Fazio, R. J. Nicholls, Paris P. Tekkis

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Abstract

Objective: The choice of ileal pouch reservoir has been a contentious subject with no consensus as to which technique provides better function. This study aimed to compare short- and long-term outcomes of three ileal reservoir designs. Method: Comparative studies published between 1985 and 2000 of J, W and S ileal pouch reservoirs were included. Meta-analytical techniques were employed to compare postoperative complications, pouch failure, and functional and physiological outcomes. Quality of life following surgery was also assessed. Results: Eighteen studies, comprising 1519 patients (689 J pouch, 306 W pouch and 524 S pouch) were included. There was no significant difference in the incidence of early postoperative complications between the three groups. The frequency of defecation over 24 h favoured the use of either a W or S pouch [J vs S: weighted mean difference (WMD) 1.48, P < 0.001; J vs W: WMD 0.97, P = 0.01]. The S pouch was associated with an increased need for pouch intubation (S vs J: OR 6.19, P = 0.04). The use of a J pouch was associated with a significantly higher prevalence of use of anti-diarrhoeal medication (J vs S: OR 2.80, P = 0.01; J vs W: OR 3.55, P < 0.001). Conclusion: All three reservoirs had similar perioperative complication rates. The S pouch was associated with the need for anal intubation. There was less frequency and less need for antidiarrhoeal agents with the W rather than the J pouch.

Original languageEnglish
Pages (from-to)310-320
Number of pages11
JournalColorectal Disease
Volume9
Issue number4
DOIs
Publication statusPublished - May 2007

Keywords

  • Adult
  • Human
  • Ileoanal pouch
  • Meta-analysis
  • Restorative proctocolectomy

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    Lovegrove, R. E., Heriot, A. G., Constantinides, V., Tilney, H. S., Darzi, A. W., Fazio, V. W., Nicholls, R. J., & Tekkis, P. P. (2007). Meta-analysis of short-term and long-term outcomes of J, W and S ileal reservoirs for restorative proctocolectomy. Colorectal Disease, 9(4), 310-320. https://doi.org/10.1111/j.1463-1318.2006.01093.x