Baker, D.M., Folan, A., Lee, M.J. orcid.org/0000-0001-9971-1635 et al. (3 more authors) (2021) A systematic review and meta‐analysis of outcomes after elective surgery for ulcerative colitis. Colorectal Disease, 23 (1). pp. 18-33. ISSN 1462-8910
Abstract
Aim
Approximately 20%–30% of patients with ulcerative colitis (UC) will undergo surgery during their disease course, the vast majority being elective due to chronic refractory disease. The risks of elective surgery are reported variably. The aim of this systematic review and meta‐analysis is to summarize the outcomes after elective surgery for UC.
Methods
A systematic review was conducted that analysed studies reporting outcomes for elective surgery in the modern era (>2002). It was prospectively registered on the PROSPERO database (ref: CRD42018115513). Searches were performed of Embase and MEDLINE on 15 January 2019. Outcomes were split by operation performed. Primary outcome was quality of life; secondary outcomes were early, late and functional outcomes after surgery. Outcomes reported in five or more studies underwent a meta‐analysis of incidence using random effects. Heterogeneity is reported with I2, and publication bias was assessed using Doi plots and the Luis Furuya‐Kanamori index.
Results
A total of 34 studies were included (11 774 patients). Quality of life was reported in 12 studies, with variable and contrasting results. Thirteen outcomes (eight early surgical complications, five functional outcomes) were included in the formal meta‐analysis, all of which were outcomes for ileal pouch–anal anastomosis (IPAA). A further 71 outcomes were reported (50 IPAA, 21 end ileostomy). Only 14 of 84 outcomes received formal definitions, with high inter‐study variation of definitions.
Conclusion
Outcomes after elective surgery for UC are variably defined. This systematic review and meta‐analysis highlights the range of reported incidences and provides practical information that facilitates shared decision making in clinical practice.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 The Authors. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/). |
Keywords: | ulcerative colitis; surgery; inflammatory bowel disease; outcomes research |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 01 Oct 2020 06:40 |
Last Modified: | 26 Jan 2022 12:09 |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1111/codi.15301 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:165362 |