The Safety and Efficiency of Surgery with Colonic Stents in Left-Sided Malignant Colonic Obstruction : A Meta-Analysis

Abstract EN

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.