Twelve randomised controlled trials (RCTs) (1,018 participants, range 20 to 271) were included. Results in the text and figures differed and here results from figures are reported.
There were no significant differences between pouch Roux-en-Y reconstruction and simple Roux-en-Y construction for total postoperative complications, anastomotic leakage, incidence of reflux symptoms or oesophagitis, eating capacity, serum albumin content, blood loss, mortality and five-year survival.
Pouch Roux-en-Y reconstruction, compared to simple Roux-en-Y reconstruction, was associated with significant improvement in quality of life (WMD 8.37, 95% CI 6.73 to 11.17, I2=40.9%; two RCTs), shorter length of hospital stay (WMD -3.01 days, 95% CI -3.41 to -2.62, I2=0%; two RCTs) and lower risk of dumping syndrome (OR 0.32, 95% CI 0.11 to 0.87, I2=0%; four RCTs).
Simple Roux-en-Y reconstruction was associated with significantly less operative time compared to pouch Roux-en-Y reconstruction (WMD 27.75 minutes, 95% CI 23.81 to 31.70, I2=49.9; five RCTs).
Funnel plots suggested evidence of publication bias.