The choice of ileal pouch reservoir has been a contentious subject with no consensus as to which technique provides better function.
Dr Tekkis and colleagues from England compared short- and long-term outcomes of 3 ileal reservoir designs.
Meta-analytical techniques were employed to compare postoperative complications, pouch failure, and functional and physiological outcomes.
The investigators assessed quality of life following surgery.
| Frequency of defecation favored the use of the W over the J pouch|
The investigative team identified 18 studies comprising 1519 patients published between 1985 and 2000.
Of these patients, 689 had a J pouch, 306 had a W pouch and 524 received the S pouch.
The investigators found no significant difference in the incidence of early postoperative complications between the 3 groups.
The frequency of defecation over 24 hours favored the use of either the W or S pouch.
The team noted that the S pouch was associated with an increased need for pouch intubation.
The investigators observed that the use of the J pouch was associated with a higher prevalence of use of anti-diarrheal medication.
Dr Tekkis' team concludes, “All 3 reservoirs had similar perioperative complication rates.”
“The S pouch was associated with the need for anal intubation.”
“There was less frequency and less need for antidiarrheal agents with the W rather than the J pouch.”