Meta-analysis of complications of colonic stenting versus emergency surgery for acute left-sided malignant colonic obstruction

Abstract

BACKGROUND: Left-sided malignant colonic obstruction is one of the most difficult clinical problems, whereas both emergency operations and colonic stenting may have their own advantages and disadvantages. The purpose of this study was to evaluate the complications of colonic stenting versus emergency surgery for acute left-sided malignant colonic obstruction. MATERIALS AND METHODS: Medline, Embase, and the Cochrane Library were searched. Only prospective randomized controlled trials that compared the 2 methods were included. Evaluation indexes in our study involved hospital death rates and complications. RESULTS: No significant difference in either hospital death rates or the overall complications between the 2 groups was found. Heterogeneity analysis found that there was no significant heterogeneity. Removing individual studies from the data editor did not substantially change the RR or the level of heterogeneity of significance for our 2 outcome measures. Testing for publication bias showed that hospital death rates and the overall complications had no serious publication bias. CONCLUSIONS: Colonic stenting was no better than emergency surgery, and should be only used as an alternative to emergency surgery carefully. © 2014 by Lippincott Williams & Wilkins.