Meta-Analysis Of The Colon J-Pouch Versus Transverse Coloplasty Pouch After Anterior Resection For Rectal Cancer

Objective To evaluate the outcome of colonic J-pouch(CJP) and transverse colonic pouches(TCP) after anterior resection for rectal cancer.Methods Trials were located through Medline,Embase,the Cochrane Central Register of Controlled Trials,VIP and CNKI.Main endpoints included functional outcomes,postoperative complications and anorectal physiological outcomes.Results 648 participants were eligible,including 326 in CJP group and 322 in TCP group.There were no difference in the incidence of anastomotic leak [odds ratio(OR) 0.50,95%confidence interval(CI) 0.21 to 1.18],chest infection(0.43,0.09 to 2.00),wound infection(0.87,0.33 to 2.30),anastomotic stricture(1.30,0.44 to 3.84),fistula(0.64,0.18 to2.31).There were no difference in functional outcomes such as stool frequency(weighted mean difference (WMD) of 0.01,-0.30 to 0.27 at 6 months postoperative ).There was no difference for anorectal physiology but heterogeneity exist:resting pressure (0.39,-1.76 to 2.55;3.09,-0.04 to 6.23;4.15,2.21 to 6.094,at preoperation, at 6 and 12 months postoperative);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,at 6 and 12 months postoperative);(Neo)rectal threshold volume(8.49,5.18 to 11.81;27.13, -5.08 to 59.35,at preoperation and 6 months postoperative);Maximal(neo) rectal volume(-14.05,-36.60 to 8.50;23.37,2.65 to 44.09;-0.54,-0.91 to -0.18,at preoperation,at 6 and 12 months postoperative)Conclusion TCP has similar results with CJP.As its safe,feasibility, simplicity,technically easy and time-saving surgical procedure,TCP is a good candidate for wide clinical application.