{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:23:48Z","timestamp":1793039028410,"version":"4.5.0"},"reference-count":42,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The aim of this systematic review and meta-analysis is to evaluate clinical, functional, and anorectal physiology outcomes of the side-to-end vs colonic J-pouch (CJP) anastomosis following anterior resection for rectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A PRISMA-compliant systematic review and meta-analysis was conducted using multiple electronic databases and clinical trial registers and all studies comparing side-to-end vs CJP anastomosis were included. Peri-operative complications, mortality rate, functional bowel, and anorectal outcomes were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight randomized controlled trials (RCTs) and two observational studies with 1125 patients (side-to-end: n = 557; CJP: n = 568) were included. Of the entire functional bowel outcome parameters analyzed, only the sensation of incomplete bowel evacuation was significant in the CJP group at 6\u00a0months [OR: 2.07; 95% CI 1.06 - 4.02, P = .03]. Peri- and post-operative clinical parameters were comparable in both groups (total operative time, intra-operative blood loss, anastomotic leak rate, return to theater, anastomotic stricture formation and mortality). Equally, most of the analyzed anorectal physiology parameters (anorectal volume, anal squeeze pressure, maximum anal volume) were not significantly different between the two groups. However, anal resting pressure (mmHg) 2\u00a0years post-operatively was noted to be significantly higher in the side-to-end group than that of the CJP configuration [MD: \u22128.76; 95% CI - 15.91 - 1.61, P = .02].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Clinical and functional outcomes following CJP surgery and side-to-end coloanal anastomosis are comparable. Neither technique appears to proffer solution to low anterior resection syndrome in the short term but future well-designed; high-quality RCTs with long term follow-up are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348231191769","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T20:46:34Z","timestamp":1690577194000},"page":"92-110","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of the Colonic J-Pouch Versus Side-To-End Anastomosis Following Low Anterior Resection: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"90","author":[{"given":"Shafquat","family":"Zaman","sequence":"first","affiliation":[{"name":"Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK"},{"name":"Cancer and Genomic Science, College of Medical and Dental Science, University of Birmingham, Edgbaston, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Peterknecht","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratik","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adewale A.","family":"Ayeni","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Gilbody","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Birmingham, Birmingham, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adil N.","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Walsall Healthcare NHS Trust, Manor Hospital, Walsall, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Y.-Y.","family":"Mohamedahmed","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinfemi","family":"Akingboye","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,28]]},"reference":[{"key":"bibr1-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)99076-7"},{"key":"bibr2-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-014-2528-y"},{"key":"bibr3-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-019-02106-x"},{"key":"bibr4-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-010-0576-1"},{"key":"bibr5-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-021-01313-0"},{"key":"bibr6-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2020.07.020"},{"key":"bibr7-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800730222"},{"key":"bibr8-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800730223"},{"key":"bibr9-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-007-9815-3"},{"key":"bibr10-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800820511"},{"issue":"10","key":"bibr11-00031348231191769","first-page":"1449","volume":"84","author":"Lazorthes F","year":"1997","journal-title":"Br J Surg"},{"key":"bibr12-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199607000-00009"},{"key":"bibr13-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800830729"},{"key":"bibr14-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6414-7"},{"issue":"5","key":"bibr15-00031348231191769","first-page":"526","volume":"35","author":"Zehnder MA","year":"1968","journal-title":"Helv Chir Acta"},{"key":"bibr16-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-011-1359-5"},{"key":"bibr17-00031348231191769","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-021-02243-0"},{"key":"bibr18-00031348231191769","unstructured":"Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). 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