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01-02-2015 | Colorectal Cancer

Comparison of Long-Term Outcomes of Colonic Stent as “Bridge to Surgery” and Emergency Surgery for Malignant Large-Bowel Obstruction: A Meta-Analysis

Authors: Akihisa Matsuda, MD, Masao Miyashita, MD, Satoshi Matsumoto, MD, Takeshi Matsutani, MD, Nobuyuki Sakurazawa, MD, Goro Takahashi, MD, Taro Kishi, MD, Eiji Uchida, MD

Published in: Annals of Surgical Oncology | Issue 2/2015

Abstract

Background

The short-term safety and efficacy of insertion of a self-expandable metallic colonic stent followed by elective surgery, bridge to surgery (BTS), for malignant large-bowel obstruction (MLBO) have been well described. However, long-term oncological outcomes are still debated. Hence, this study is conducted to evaluate long-term outcomes of colonic stent insertion followed by surgery for MLBO.

Methods

A comprehensive electronic literature search through May 2014 was performed to identify studies comparing long-term outcomes between BTS and emergency surgery for MLBO. The main outcome measures were overall survival (OS), disease-free survival (DFS), and recurrence. A meta-analysis was performed using random-effects models to calculate risk ratios (RRs) with 95 % confidence intervals (95 % CIs).

Results

There were 11 studies that matched the criteria for inclusion, yielding a total of 1136 patients, of whom 432 (38.0 %) underwent BTS and 704 (62.0 %) underwent emergency surgery. In OS analyses of all patients and patients who underwent curative resection, BTS was similar to emergency surgery [(RR = 0.95; 95 % CI 0.75–1.21; P = 0.66) (RR = 0.96; 95 % CI 0.67–1.37; P = 0.82), respectively]. DFS (RR = 1.06; 95 % CI 0.91–1.24; P = 0.43) and recurrence (RR = 1.13; 95 % CI 0.82–1.54; P = 0.46) did not differ significantly between the BTS and emergency surgery groups.

Conclusions

Results of this meta-analysis on long-term as well as well-described short-term outcomes suggest that BTS could be a promising alternative strategy for MLBO patients.

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Title: Comparison of Long-Term Outcomes of Colonic Stent as “Bridge to Surgery” and Emergency Surgery for Malignant Large-Bowel Obstruction: A Meta-Analysis
Authors: Akihisa Matsuda, MD
Masao Miyashita, MD
Satoshi Matsumoto, MD
Takeshi Matsutani, MD
Nobuyuki Sakurazawa, MD
Goro Takahashi, MD
Taro Kishi, MD
Eiji Uchida, MD
Publication date: 01-02-2015
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 2/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-3997-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of Long-Term Outcomes of Colonic Stent as “Bridge to Surgery” and Emergency Surgery for Malignant Large-Bowel Obstruction: A Meta-Analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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