{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T01:16:51Z","timestamp":1773019011151,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ileal pouch anal anastomosis (IPAA) prolapse is a rare mechanical complication, with a paucity of literature on frequency and management. This study aimed to assess the prevalence and management outcomes of perineal salvage procedures (SPs) for IPAA prolapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Systematic search conducted in PubMed and Scopus with an additional search of relevant cross\u2010referenced literature on experimental and observational human studies involving IPAA for ulcerative colitis or familial adenomatous polyposis from database inception to March 2023. Risk of bias assessment was performed using the NIH quality assessment tool for observational cohort and cross\u2010sectional studies. Meta\u2010analysis was performed by standard methodology using a random\u2010effect model. Main outcome measure was the success rate of perineal SPs for pouch prolapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010two publications were screened; 3 observational studies met the inclusion criteria. Included studies comprised 27,061 patients who underwent IPAAs over a 37\u2010year study period. Ninety\u2010five patients had IPAA prolapse and pooled prevalence of 0.4% (95% CI: 0.3\u20130.4;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%). Patient age ranged from 31.6 to 38\u2009years with a male\u2010to\u2010female ratio of 1.2:1. Time to prolapse from primary IPAA construction was heterogeneously reported as 2.6\u2009years [&lt;2\u2009years (48%), and \u22653\u2009years (47%)]. Pouch advancement was most frequently reported (88.4%; 95% CI: 77.5\u201399.3). Overall morbidity and success rates were 23% and 90.5%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Studies were heterogeneous. Perineal SPs were infrequently performed for the uncommon IPAA complication of prolapse, with good outcomes in mucosal prolapse. There is insufficient evidence on functional status and quality of life following perineal SPs for full\u2010thickness prolapse.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70202","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T04:17:12Z","timestamp":1756181832000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perineal salvage surgery for prolapse of ileal pouch anal anastomosis: Systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6795-6408","authenticated-orcid":false,"given":"Emeka","family":"Ray\u2010Offor","sequence":"first","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida  Weston Florida USA"},{"name":"Department of Surgery University of Port Harcourt Teaching Hospital  Port Harcourt Rivers State 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