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A systematic review and meta-analysis of outcomes after elective surgery for ulcerative colitis.
Baker, D M; Folan, A-M; Lee, M J; Jones, G L; Brown, S R; Lobo, A J.
Afiliación
  • Baker DM; Academic Foundation Doctor, Sheffield Teaching Hospitals, Sheffield, UK.
  • Folan AM; Department of Psychology, School of Social Sciences, Leeds Beckett University, Leeds, UK.
  • Lee MJ; Academic Directorate Sheffield Teaching Hospitals, Sheffield, UK.
  • Jones GL; Department of Oncology and Metabolism, Sheffield Medical School, Sheffield, UK.
  • Brown SR; Department of Psychology, School of Social Sciences, Leeds Beckett University, Leeds, UK.
  • Lobo AJ; Department of General Surgery, Sheffield Teaching Hospitals, Sheffield, UK.
Colorectal Dis ; 23(1): 18-33, 2021 Jan.
Article en En | MEDLINE | ID: mdl-32777171
AIM: Approximately 20%-30% of patients with ulcerative colitis (UC) will undergo surgery during their disease course, the vast majority being elective due to chronic refractory disease. The risks of elective surgery are reported variably. The aim of this systematic review and meta-analysis is to summarize the outcomes after elective surgery for UC. METHODS: A systematic review was conducted that analysed studies reporting outcomes for elective surgery in the modern era (>2002). It was prospectively registered on the PROSPERO database (ref: CRD42018115513). Searches were performed of Embase and MEDLINE on 15 January 2019. Outcomes were split by operation performed. Primary outcome was quality of life; secondary outcomes were early, late and functional outcomes after surgery. Outcomes reported in five or more studies underwent a meta-analysis of incidence using random effects. Heterogeneity is reported with I2 , and publication bias was assessed using Doi plots and the Luis Furuya-Kanamori index. RESULTS: A total of 34 studies were included (11 774 patients). Quality of life was reported in 12 studies, with variable and contrasting results. Thirteen outcomes (eight early surgical complications, five functional outcomes) were included in the formal meta-analysis, all of which were outcomes for ileal pouch-anal anastomosis (IPAA). A further 71 outcomes were reported (50 IPAA, 21 end ileostomy). Only 14 of 84 outcomes received formal definitions, with high inter-study variation of definitions. CONCLUSION: Outcomes after elective surgery for UC are variably defined. This systematic review and meta-analysis highlights the range of reported incidences and provides practical information that facilitates shared decision making in clinical practice.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colitis Ulcerosa / Proctocolectomía Restauradora / Reservorios Cólicos Tipo de estudio: Etiology_studies / Prognostic_studies / Systematic_reviews Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colitis Ulcerosa / Proctocolectomía Restauradora / Reservorios Cólicos Tipo de estudio: Etiology_studies / Prognostic_studies / Systematic_reviews Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido