Meta-analysis of safety and efficacy of self-expending metallic stents as bridge to surgery versus emergency surgery for left-sided malignant colorectal obstruction / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of self-expending metallic stents (SEMS) as bridge to surgery versus emergency surgery for left-sided malignant colorectal obstruction.</p><p><b>METHODS</b>A comprehensive literature search of CENTRAL, PubMed, EMBASE, Medline, Ovid LWW, CMB, CNKI and Wanfang Databases were performed for all randomized controlled trials or retrospective studies comparing self-expending metallic stents as bridge to surgery(SABS group) with emergency surgery (ES group). A meta-analysis was carried out by RevMan5.1 software on the outcomes concerning safety and efficacy of the two groups.</p><p><b>RESULTS</b>Fourteen studies matched the criteria including 1083 patients. Five were randomized controlled trials and nine were retrospective analysis. Compared with the ES group, the SABS group had a lower short-term mortality(RR=0.52, 95% CI0.30-0.93, P<0.05), lower overall complications(RR=0.46, 95% CI0.31-0.70, P<0.05), higher resection rate(RR=1.90, 95%CI1.33-2.70, P<0.01), shorter operative time(MD=-59.77, 95%CI-87.51--32.04, P<0.01), and shorter interval to first flatus(MD=-10.78, 95%CI-16.67--4.90, P<0.01). There were no statistically significant differences between the two groups in permanent stomy and hospital stay.</p><p><b>CONCLUSION</b>The safety and efficacy of self-expending metallic stents as bridge to surgery for left-sided malignant colorectal obstruction is superior to emergency surgery.</p>