@entity5 After Colectomy in XXXX With @entity29 : A Systematic Review and Meta-analysis.

@entity1 @entity5 @entity254 @entity29 @entity14 @entity9
BACKGROUND _ AIMS: @entity14 can still develop after colectomy for @entity29 . However, data on this risk are scare, and there have been few conclusive findings, so no evidence-based recommendations have been made for postoperative surveillance. We conducted a systematic review and meta-analysis to determine the prevalence and incidence of and risk factors for @entity5 in @entity1 with @entity29 who have undergone colectomy, including the permanent-end @entity9 , @entity254 ( @entity254 ), and ileal pouch-anal @entity254 (IPAA) procedures. METHODS: We searched PubMed, Embase, Web of Science, and Cochrane Library through May 2014 to identify studies that reported prevalence or incidence of @entity14 after colectomy or specifically assessed risk factors for @entity5 development. Studies were selected, quality was assessed, and data were extracted by 2 independent researchers. RESULTS: We calculated @entity14 ( @entity14 ) prevalence values from 13 studies of @entity1 who underwent rectal stump surgery, 35 studies of @entity254 , and 33 studies of IPAA. Significantly higher  proportions of @entity1 in the rectal stump group (2.1%; 95% confidence interval [CI], 1.3%-3.0%) and in the @entity254 group (2.4%; 95% CI, 1.7%-3.0%) developed @entity14 than in the IPAA group (0.5%; 95% CI, 0.3%-0.6%); the odds ratio (OR) for @entity14 in the rectal stump or @entity254 groups compared with the IPAA group was 6.4 (95% CI, 4.3-9.5). A history of @entity14 was the most important risk factor for development of @entity14 after colectomy (OR for @entity1 receiving @entity254 , 12.8; 95% CI, 3.31-49.2 and OR for @entity1 receiving IPAA, 15.0; 95% CI, 6.6-34.5). CONCLUSIONS: In a meta-analysis of published studies, we found the prevalence and incidence of @entity14 after colectomy to be less than 3%; in @entity1 receiving IPAA it was less than 1%. Factors that increased risk of @entity5 development after colectomy included the presence of a residual rectum and a history of @entity14 . These findings could aid in development of individualized strategies for post-surgery surveillance.
