The safety and efficiency of surgery with colonic stents in left-sided malignant colonic obstruction: A meta-analysis

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Abstract

<p> <italic>Objective.</italic> 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). <italic>Methods.</italic> 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. <italic>Result.</italic> 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%, <math id="M1"> <mi>P</mi> <mo>=</mo> <mn>0.02</mn> </math> ), surgical site infection rate (10.2% versus 19.7%, <math id="M2"> <mi>P</mi> <mo>=</mo> <mn>0.03</mn> </math> ), and overall complication rate (29.2% versus 60.5%, <math id="M3"> <mi>P</mi> <mo>=</mo> <mn>0.05</mn> </math> ). There was no statistic difference for the rate of primary anastomosis, anastomotic leak and operation-related mortality between two groups. <italic>Conclusions.</italic> semielective surgery with SEMS as a bridge for proper patients of LMCO can lower the overall rate for colostomy, surgical site infection, and complications. </p>

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Zhao, X., Liu, B., Zhao, E., Wang, J., Cai, M., Xia, Z., … Cai, K. (2014). The safety and efficiency of surgery with colonic stents in left-sided malignant colonic obstruction: A meta-analysis. Gastroenterology Research and Practice, 2014. https://doi.org/10.1155/2014/407325

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