Loop transverse colostomy versus loop ileostomy for defunctioning of colorectal anastomosis: a systematic review, updated conventional meta-analysis, and cumulative meta-analysis

AbstractDefunctioning of colorectal anastomosis either with loop transverse colostomy or ileostomy was evaluated using updated and cumulative meta-analyses. Studies were identified by a systematic search of Embase, PubMed, Cochrane Library, and Google Scholar databases and were selected as per the PRISMA checklist. Both randomised control trials (RCTs) and retrospective studies were included. A sensitivity analysis was performed, and a cumulative meta-analysis was performed to monitor evidence over time. Significantly more male patients underwent loop ileostomy than transverse colostomy [odds ratio (OR)  = 0.59 (95% confidence interval (CI) 0.39, 0.90),p <  0.001,I2 = 48%]. Significantly more colostomies were complicated by stoma prolapse than by ileostomies [OR = 6.32 (95% CI 2.78, 14.35),p <  0.001,I2 = 0%). Patients with ileostomy demonstrated a significantly higher complication rate of high-output stoma than patients with colostomies [Peto OR = 0.16 (95% CI 0.04, 0.55),p = 0.004,I2 = 0%]. Patients with colostomies demonstrated significantly more complications related to stoma reversal, such as wound infections and incisional hernias, than patients with ileostomies [OR = 3.45 (95% CI 2.00, 5.95),p <  0.001,I2 = 0%; OR = 4.80 (95% CI 1.85, 12.44),p <  0.001,I2 = 0%, respectively]. Overall complications related to stoma formation and closure did not demonstrate significant differences; however, theirI2 v...
Source: Surgery Today - Category: Surgery Source Type: research