Postoperative complications of colectomy and J- pouch with ileostomy versus without ileostomy in children with inflammatory bowel diseases: a systematic review and meta- analysis  

作　　者：Irina Oltean Nicole Travis Manvinder Kaur Viviane Grandpierre Lamia Hayawi Anne Tsampalieros Ahmed Nasr 

机构地区：[1]Department of Surgery,Children's Hospital of Eastern Ontario,Ottawa,Ontario,Canada [2]Children's Hospital of Eastern Ontario Research Institute,Clinical Research Unit,Ottawa,Ontario,Canada [3]University of Ottawa,Ottawa,Ontario,Canada

出　　处：《World Journal of Pediatric Surgery》2022年第2期38-45,共8页世界小儿外科杂志（英文）

摘　　要：Background The efficacy of performing a restorative proctocolectomy and J-pouch ileoanal anastomosis without diverting ileostomy in children with inflammatory bowel disease has been a longstanding debate.A systematic review and meta-analysis is presented comparing the occurrence of postoperative complications in children who underwent either the pouch-anal anastomosis(IPAA)with ileostomy(diverted)versus the undiverted procedure.Methods Records were sourced from CINAHL,CENTRAL,EMBASE and MEDLINE databases.Studies followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and compared postoperative complications in pediatric patients diagnosed with inflammatory diseases aged less than 18 years who underwent J-pouch with ileostomy versus without ileostomy.The primary outcome was the occurrence of postoperative leaks,and the secondary outcomes were presence of postoperative small bowel obstruction(SBO),pouchitis,stricture and fistula complications.A random-effects meta-analysis was used.Results Twenty-three observational studies in the systematic review were included with 658 patients(83%diverted,17%undiverted).Pooled estimates showed no difference in occurrence of leaks in children who underwent J-pouch/IPAA with ileostomy versus without(odds ratio(OR)0.54,95%confidence interval(CI)0.17 to 1.64,I^(2)=16%).There was no difference in the occurrence of SBO,pouchitis or strictures in children who underwent J-pouch/IPAA with ileostomy versus without(SBO:OR 2.27,95%CI 0.52 to 9.92,I^(2)=0%,pouchitis:OR 1.76,95%CI 0.95 to 3.24,I^(2)=0%,strictures:OR 2.72,95%CI 0.44 to 16.69,I^(2)=66%).Conclusion The meta-analysis did not find differences in the occurrence of complications in pediatric patients who underwent the IPAA with ileostomy procedure versus without ileostomy.

关 键 词：COMPLICATIONS BOWEL DISEASES 

分 类 号：R725.7[医药卫生—儿科]