The Safety and Efficiency of Surgery with Colonic Stents in Left-Sided Malignant Colonic Obstruction: A Meta-Analysis. (13th May 2014)

• Record Type: Journal Article
• Authors: Zhao, Xiang; Liu, Bo; Zhao, Ende; Wang, Jiliang; Cai, Ming; Xia, Zefeng; Xia, Qinghua; Shuai, Xiaoming; Tao, Kaixiong; Wang, Guobin; Cai, Kailin
• Other Names: Morini Sergio Academic Editor.
• Is Part Of: Gastroenterology research and practice. Volume 2014(2014)
• Publication Date: 2014-05-13
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33005
• DOI: 10.1155/2014/407325
• Languages: English
• ISSNs: 1687-6121

Abstract

Abstract : Objective. This meta-analysis is aimed at assessing the safety and efficiency of colonic self-expanding metallic stents (SEMS) used as a bridge to surgery in the management of left-sided malignant colonic obstruction (LMCO). Methods. A systematic search was conducted in PubMed, Web of Knowledge, OVID, Google Scholar, CNKI, and WANGFANG for relevant randomized trials comparing colonic stenting used as a bridge in semielective surgery versus emergency surgery from January 2001 to September 2013. Result. Five published studies were included in this systematic review, including 273 patients (140 male/133 female). 136 patients received semielective surgery after SEMS installation while 137 patients underwent emergency surgery without SEMS. SEMS intervention resulted in significantly lower overall colostomy rate (41.9% versus 56.2%, P = 0.02 ), surgical site infection rate (10.2% versus 19.7%, P = 0.03 ), and overall complication rate (29.2% versus 60.5%, P = 0.05 ). There was no statistic difference for the rate of primary anastomosis, anastomotic leak and operation-related mortality between two groups. Conclusions. semielective surgery with SEMS as a bridge for proper patients of LMCO can lower the overall rate for colostomy, surgical site infection, and complications.