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- Title
Colonic stent as a bridge to surgery versus emergency resection for right-sided malignant large bowel obstruction: a meta-analysis.
- Authors
Kanaka, Shintaro; Matsuda, Akihisa; Yamada, Takeshi; Ohta, Ryo; Sonoda, Hiromichi; Shinji, Seiichi; Takahashi, Goro; Iwai, Takuma; Takeda, Kohki; Ueda, Koji; Kuriyama, Sho; Miyasaka, Toshimitsu; Yoshida, Hiroshi
- Abstract
<bold>Background: </bold>Preoperative colonic stenting for malignant large bowel obstruction (MLBO), also called bridge to surgery (BTS), is considered a great substitute treatment for emergency resection (ER) in the left-sided colon. However, its efficacy in the right-sided colon remains controversial. This systematic review and meta-analysis aimed to compare the postoperative short-term outcomes between BTS and ER for right-sided MLBO.<bold>Methods: </bold>A comprehensive electronic literature search throughout December 2020 was performed to identify studies comparing short-term outcomes between BTS and ER for right-side MLBO. The main outcome measures were postoperative complications and mortality rates. A meta-analysis was performed using a fixed-effect or a random-effect method to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs).<bold>Results: </bold>Seven studies were included in this meta-analysis, comprising 5136 patients, of whom 1662 (32.4%) underwent BTS and 3474 (67.6%) underwent ER. This meta-analysis demonstrated that BTS resulted in reductions in postoperative complications (OR = 0.78; 95% CI: 0.66-0.92) and mortality (OR = 0.51; 95% CI: 0.28-0.92) than ER.<bold>Conclusion: </bold>The results of this meta-analysis indicate that BTS for right-sided MLBO confers preferable short-term outcomes as well as for left-sided. This suggests that BTS results in a reduction of postoperative complications and mortality for right-sided MLBO than ER.
- Subjects
SURGICAL stents; BOWEL obstructions; SURGICAL emergencies; SURGICAL complications; FIXED effects model; HYPERTEXT literature; LARGE intestine; COLON tumors; META-analysis; SYSTEMATIC reviews; RETROSPECTIVE studies; COLORECTAL cancer; TREATMENT effectiveness; DISEASE complications
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2022, Vol 36, Issue 5, p2760
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-022-09071-7