title: Meta-analysis of the colon J-pouch vs transverse coloplasty pouch after anterior resection for rectal cancer.
abstract: OBJECTIVE
  To evaluate the outcome of colonic J-pouches (CJP) and transverse colonic pouches (TCPs) after anterior resection for rectal cancer.
  
  
  METHODS
  Trials were located through Medline, Embase, the Cochrane Central Register of Controlled Trials, VIP and CNKI. Main end-points included functional outcomes, postoperative complications and anorectal physiological outcomes.
  
  
  RESULTS
  Of 120 articles, 34 compared CJP and TCP. Of these only six were randomized controlled trials (RCT), which fulfilled the inclusion criteria. These six included 648 patients, including 326 in the CJP group and 322 in the TCP group. There were no differences in the incidences of anastomotic leak [odds ratio 0.50, 95% confidence interval (CI) 0.21-1.18], chest infection (0.43, 0.09-2.00), wound infection (0.87, 0.33-2.30), anastomotic stricture (1.30, 0.44-3.84), fistula (0.64, 0.18-2.31).There were no difference in functional outcomes such as stool frequency [weighted mean difference (WMD) of -0.01, -0.30-0.27 at 6 months].There was no difference for anorectal physiology but heterogeneity existed: resting pressure (0.39, -1.76 to 2.55; 3.09, -0.04 to 6.23; 4.15, 2.21-6.094, at preoperation, 6 and 12 months,); squeeze pressure (-15.02, -46.14 to 16.10; -15.04, -37.04 to 6.97;0.83, -7.70 to 9.37 at preoperation, 6 and 12 months);(Neo)rectal threshold volume(8.49, 5.18-11.81; 27.13, -5.08 to 59.35, at preoperation and 6 months); Maximal (neo) rectal volume (-14.05, -36.60 to 8.50; 23.37, 2.65-44.09; -0.54, -0.91 to -0.18, at preoperation, 6 and at 12 months).
  
  
  CONCLUSIONS
  Transverse colonic pouch has similar results as CJP. As it is a safe, feasible, simple, technically easy and time-saving surgical procedure, TCP is a good candidate for wider clinical application.
authors: Department of Colorectal and Anal Surgery, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China.
authors: C
authors: C
authors: Liao
authors: F
authors: F
authors: Gao
authors: Y
authors: Y
authors: Cao
authors: A
authors: A
authors: Tan
authors: X
authors: X
authors: Li
authors: D
authors: D
authors: Wu
mesh_terms: D000714:Anastomosis, Surgical; D039021:Colonic Pouches; D006801:Humans; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D012086:Reoperation