{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:04:19Z","timestamp":1782299059289,"version":"3.54.5"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Restorative proctocolectomy with transabdominal ileal pouch\u2013anal anastomosis (abd\u2010IPAA) has become the standard surgical treatment for medically refractory ulcerative colitis (UC). However, it requires a technically difficult distal anorectal dissection and anastomosis due to the bony confines of the deep pelvis. To address these challenges, the transanal IPAA approach (ta\u2010IPAA) was developed. This novel approach may offer increased visibility and range of motion compared with abd\u2010IPAA, although its postoperative benefits remain unclear. The aim of this work was to perform a systematic review and meta\u2010analysis to compare and inform the frequency of postoperative outcomes between ta\u2010IPAA and abd\u2010IPAA for patients with UC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Several databases were searched from inception until May 2022 for studies reporting postoperative outcomes of patients undergoing ta\u2010IPAA. Reviewers, working independently and in duplicate, evaluated studies for inclusion and graded the risk of bias. Odds ratios (OR), mean differences (MD) and prevalence ratio (PR) and their corresponding 95% confidence intervals (CIs) were calculated using random\u2010effects models. Sensitivity analysis was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten retrospective studies comprising 284 patients with ta\u2010IPAA were included. Total mesorectal excision was performed in 61.8% of cases and close rectal dissection in 27.9%. There was no difference in the odds of Clavien\u2013Dindo (CD) I\u2013II complications, CD III\u2013IV and anastomotic leak (OR 0.96, 95% CI 0.27\u20133.40; OR 1.18, 95% CI 0.65\u20132.16; OR 1.37, 95% CI 0.58\u20133.23; respectively) between ta\u2010IPAA and abd\u2010IPAA. The ta\u2010IPAA pooled CD I\u2013II complication rate was 18% (95% CI 5%\u201335%) and for CD III\u2013IV 10% (95% CI 5%\u201317%), and the anastomotic leak rate was 6% (95% CI 2%\u201310%). There were no deaths reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This meta\u2010analysis compared the novel ta\u2010IPAA procedure with abd\u2010IPAA and found no difference in postoperative outcomes. While the need for randomized controlled trails and comparison of functional outcomes between both approaches remains, this evidence should assist colorectal surgeons to decide if ta\u2010IPAA is a viable alternative.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16977","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T04:44:02Z","timestamp":1712724242000},"page":"886-898","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Transanal ileal pouch\u2013anal anastomosis for inflammatory bowel disease: a systematic review and meta\u2010analysis of short\u2010term outcomes"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4668-7429","authenticated-orcid":false,"given":"Eddy P.","family":"Lincango","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar Hernandez","family":"Dominguez","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Prien","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Duraes","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8397-573X","authenticated-orcid":false,"given":"Tarin","family":"Uchino","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6082-9345","authenticated-orcid":false,"given":"Jean","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Lipman","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8632-6065","authenticated-orcid":false,"given":"David","family":"Liska","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy L.","family":"Hull","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Valente","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott R.","family":"Steele","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2549-9042","authenticated-orcid":false,"given":"Stefan D.","family":"Holubar","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,9]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/AJG.2012.127"},{"key":"e_1_2_13_3_1","first-page":"309","article-title":"Laparoscopic pouch surgery in ulcerative colitis","volume":"25","author":"Hemandas AK","year":"2012","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/BJS.7759"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/BJS.9701"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/BJS.9061"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00464\u2010007\u20109294\u20109"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13359"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ases.12646"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002395"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010018\u20101889\u20108"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ECCO\u2010JCC\/JJZ174"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2021.0115"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010021\u201005236\u20102"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.14309\/01.ajg.0000897648.75911.71"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.IJSU.2021.105906"},{"key":"e_1_2_13_17_1","first-page":"2008","article-title":"Meta\u2010analysis of observational studies in epidemiology: a proposal for reporting\u2010meta\u2010analysis of observational studies in epidemiology (MOOSE) group B","volume":"283","author":"Stroup DF","year":"2000","journal-title":"JAMA Neurol."},{"key":"e_1_2_13_18_1","unstructured":"Veritas Health Innovation.Covidence systematic review software.www.covidence.orgAccessed May 11 2022."},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_13_20_1","volume-title":"The Newcastle\u2013Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta\u2010Analyses","author":"Wells G","year":"2024"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm\u20102017\u2010110853"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020\u2010020\u201002588\u20108"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.2307\/2331986"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2164"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177729756"},{"issue":"13","key":"e_1_2_13_26_1","first-page":"1","article-title":"Simulation\u2010based comparison of methods for meta\u2010analysis of proportions and rates","volume":"13","author":"Trikalinos TA","year":"2013","journal-title":"Methods Res Rep."},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197\u20102456(86)90046\u20102"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280216669183"},{"issue":"2","key":"e_1_2_13_29_1","first-page":"151","article-title":"Weighted means and weighting functions","volume":"42","author":"Mesiar R","year":"2006","journal-title":"Kybernetik."},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.31801\/cfsuasmas.530462"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_13_32_1","unstructured":"R Core Team.R: A Language and Environment for Satistical Computing.2020https:\/\/www.r\u2010project.org"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12893\u2010020\u201001007\u2010Z"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JPEDSURG.2020.12.010"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010020\u201002154\u20104"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00464\u2010017\u20105542\u20109"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00464\u2010015\u20104087\u2010Z"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/S13037\u2010021\u201000306\u20105"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/BMJ.2.6130.85"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.3748\/WJG.V25.I31.4320"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/S11605\u2010019\u201004443\u20102"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2014.08.012"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003597"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15301"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/AS9.0000000000000074"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/S11605\u2010008\u20100665\u2010X"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199508000\u201000003"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010200006000\u201000017"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5464"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010020\u201007935\u20104"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.16977","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T04:49:34Z","timestamp":1716612574000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.16977"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,9]]},"references-count":49,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/codi.16977"],"URL":"https:\/\/doi.org\/10.1111\/codi.16977","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,9]]},"assertion":[{"value":"2023-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}