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 24 May 2018

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News

Fewer antidiarrheal agents required with W ileal pouch

April's Colorectal Disease reports reduced frequency, need for antidiarrhoeal agents or anal intubation with the W than with the J or S pouches.

News image

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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
Colorectal Disease

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.”

Colorectal Dis 2007: 9(4): 310-20
18 April 2007

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