Academic Journal
Ileorectal anastomosis in patients with Crohn's disease. Postoperative complications and functional outcome-a systematic review
| العنوان: | Ileorectal anastomosis in patients with Crohn's disease. Postoperative complications and functional outcome-a systematic review |
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| المؤلفون: | Baelum, Jens Kristian, Qvist, Niels, Ellebaek, Mark Bremholm |
| المصدر: | Baelum , J K , Qvist , N & Ellebaek , M B 2021 , ' Ileorectal anastomosis in patients with Crohn's disease. Postoperative complications and functional outcome-a systematic review ' , Colorectal Disease , vol. 23 , no. 10 , pp. 2501-2514 . https://doi.org/10.1111/codi.15839 |
| سنة النشر: | 2021 |
| المجموعة: | University of Southern Denmark: Research Output / Syddansk Universitet |
| مصطلحات موضوعية: | Crohn´s disease, anastomotic leak, ileorectal anastomosis, Anastomosis, Surgical/adverse effects, Humans, Neoplasm Recurrence, Local, Rectum/surgery, Colectomy, Postoperative Complications/epidemiology, Crohn Disease/surgery, Quality of Life, Retrospective Studies, Ileum/surgery |
| الوصف: | AIM: The objective of this systematic review was to investigate the outcomes of ileorectal anastomosis (IRA) in Crohn's disease and to clarify whether there are any time-related trends in outcome measures. The primary outcomes are risk of anastomotic leakage, death, clinical recurrence and subsequent diverting or permanent stoma and/or proctectomy. Secondary end-points are quality of life and functional outcome. METHODS: Systematic searches were conducted using the Cochrane Library, Embase and MEDLINE. The complete search strategy is uploaded online at http://www.crd.york.ac.uk/prospero/. Human studies in English with over five subjects were included and no limit was set regarding the date of publication. All relevant studies were screened by two reviewers. The web-based software platform www.covidence.org was used for primary screening of the title, abstract, full-text review and data extraction. RESULTS: The search identified 2231 unique articles. After the screening process, 37 remained. Key results were an overall anastomotic leak rate of 6.4%; cumulative rates of clinical recurrence of 43% and 67% at 5 and 10 years, respectively; an overall rate of proctectomy of 18.9%; and subsequent ileostomy required in 18.8%. Only one study presented useful data on quality of life. Recurrence rates remained stable over time. A small decline in the anastomotic leak rate was found. CONCLUSIONS: Only minor improvements in the outcomes of IRA in patients with Crohn´s disease have occurred during the past 50 years regarding anastomotic leakage and recurrence, except for a slight increase in the rate of a functioning IRA. These results call for implementation guidelines in patient selection for IRA and postoperative medical treatment and follow-up. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| DOI: | 10.1111/codi.15839 |
| الاتاحة: | https://portal.findresearcher.sdu.dk/da/publications/979ca8ea-15b9-4a96-9ffe-102ad5deb631 https://doi.org/10.1111/codi.15839 https://findresearcher.sdu.dk/ws/files/191977721/codi.15839.pdf |
| Rights: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.C6A269B2 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1111/codi.15839 |
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