{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:49:15Z","timestamp":1793321355738,"version":"4.5.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Tech Coloproctol"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>A significant number of patients experience complications of the Kock pouch (KP) warranting revision or excision. This systematic review aimed to assess the pooled prevalence and risk factors for complications and failure of the KP.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-compliant systematic review (CRD42023416961) searched PubMed, Scopus, and Web of Science for studies on adult patients with Kock continent ileostomy published after the year 2000. The main outcome measures were revision, complications, and failure of the KP. Risk factors for complications and failure were assessed using a meta-regression analysis. Risk of bias was assessed using the ROBINS-1 tool. A proportional meta-analysis of the main outcomes was performed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 19 studies (2042 patients) were included. The weighted mean prevalence of complications was 60.4% [95% confidence interval (CI): 46.1\u201374.7%], of pouch revision was 46.6% (95% CI: 38.5\u201354.7%), and of pouch failure was 12.9% (95% CI: 9.3\u201316.4%). Studies conducted in the USA had a mean failure prevalence of 12.6% (95% CI: 6.2\u201318.9%) comparable to studies conducted in Europe (11.1%; 95% CI: 7.5\u201314.7%). Factors associated with higher complications were increased body mass index (BMI) and previous ileoanal pouch anastomosis (IPAA); however, these factors were not associated with increased pouch failure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The KP is a highly complex operation as shown by a pooled complication prevalence of 60%, and thus, it should be only performed by experienced surgeons. Despite the high prevalence of complications and need for revisional surgery, patients are keen to preserve their KP. Increased BMI and a previous failed IPAA are risk factors for pouch complications, but not failure.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10151-024-03018-x","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T18:01:43Z","timestamp":1727805703000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Complications and failure after Kock continent ileostomy: A systematic review and meta-analysis"],"prefix":"10.1007","volume":"28","author":[{"given":"S. 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Dr. Wexner is a consultant for ARC\/Corvus, Baxter, Becton, Dickinson and Co, GI Supply, Glaxo Smith Kline, ICON Clinical Research Ltd, Intuitive Surgical, Leading Biosciences\/PalisadeBio, Livsmed, Medtronic, Olympus, OstomyCure, Stryker, Takeda, Virtual Ports; is a member of the Data Safety Monitoring Board of JSR\/WCG\/ACI (chair), Polypoid (chair), and Boomerang; and receives royalties from Intuitive Surgical Karl Storz Endoscopy America Inc., Medtronic, and Unique Surgical Solutions, LLC.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"135"}}