BACKGROUND: Temporary faecal diversion is sometimes used for management of refractory perianal @entity30 ( @entity30 ) with variable success. AIMS: To perform a systematic review with meta-analysis to evaluate the effectiveness, long-term outcomes and factors associated with success of temporary faecal diversion for perianal @entity30 . METHODS: Through a systematic literature review through 15 July 2015, we identified 16 cohort studies (556 @entity1 ) reporting outcomes after temporary faecal diversion. We estimated pooled rates [with 95% confidence interval (CI)] of early clinical response, attempted and successful restoration of bowel continuity after temporary faecal diversion (without symptomatic relapse), and rates of re-diversion (in @entity1 with attempted restoration) and proctectomy (with or without colectomy and end-ileostomy). We identified factors associated with successful restoration of bowel continuity. RESULTS: On meta-analysis, 63.8% (95% CI: 54.1-72.5) of @entity1 had early clinical response after faecal diversion for refractory perianal @entity30 . Restoration of bowel continuity was attempted in 34.5% (95% CI: 27.0-42.8) of @entity1 , and was successful in only 16.6% (95% CI: 11.8-22.9). Of those in whom restoration was attempted, 26.5% (95% CI: 14.1-44.2) required re-diversion because of severe relapse. Overall, 41.6% (95% CI: 32.6-51.2) of @entity1 required proctectomy after failure of temporary faecal diversion. There was no difference in the successful restoration of bowel continuity after temporary faecal diversion in the pre-biological or biological era (13.7% vs. 17.6%, P  =  0.60), in part due to selection bias. Absence of rectal involvement was the most consistent factor associated with restoration of bowel continuity. CONCLUSIONS: Temporary faecal diversion may improve symptoms in approximately two-thirds of @entity1 with refractory perianal @entity30 , but bowel restoration is successful in only 17% of @entity1 .

Systematic review with meta-analysis: faecal diversion for management of perianal XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity30 :: ('MESH:D003424', 'Disease') :: ['CD', "Crohn's disease"]
@entity30 :: (MESH:D003424,Disease) :: ['Crohn's disease']
