Systematic review and meta-analysis of randomized clinical trials of self-expanding metallic stents as a bridge to surgery versus emergency surgery for malignant left-sided large bowel obstruction

2012 ◽  
Vol 99 (4) ◽  
pp. 469-476 ◽  
Author(s):  
C. J. Tan ◽  
B. V. M. Dasari ◽  
K. Gardiner
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Large Bowel ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Large Bowel Obstruction ◽  
Metallic Stents ◽  
Bridge To Surgery

scholarly journals Endoscopic Stenting as Bridge to Surgery versus Emergency Resection for Left-Sided Malignant Colorectal Obstruction: An Updated Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Niccolò Allievi ◽  
Marco Ceresoli ◽  
Paola Fugazzola ◽  
Giulia Montori ◽  
Federico Coccolini ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Large Bowel ◽  
Meta Analysis ◽  
Large Bowel Obstruction ◽  
Endoscopic Stenting ◽  
Bridge To Surgery ◽  
Colorectal Obstruction ◽  
Pubmed Database ◽  
Emergency Resection

Introduction. Emergency resection represents the traditional treatment for left-sided malignant obstruction. However, the placement of self-expanding metallic stents and delayed surgery has been proposed as an alternative approach. The aim of the current meta-analysis was to review the available evidence, with particular interest for the short-term outcomes, including a recent multicentre RCT. Methods. We considered randomized controlled trials comparing stenting as a bridge to surgery and emergency surgery for the management of left-sided malignant large bowel obstruction, performing a systematic review in MEDLINE, PubMed database, and the Cochrane libraries. Results. We initially identified a total of 2543 studies. After the elimination of duplicates and the screening of titles and abstracts, seven studies, for a total of 448 patients, were considered. The current meta-analysis revealed no difference in the mortality rate between the stent group and the emergency surgery group; the postoperative complication rate (37.84% versus 54.87%, P=0.02), the stoma rate (28.8% versus 46.02%, P<0.0001), and the incidence of wound infection (8.11% versus 15.49%, P=0.01) were reduced after stent as a bridge to surgery. Conclusion. Colonic stenting as a bridge to surgery appears to be a safe approach to malignant large bowel obstruction. Possible advantages of this treatment can be identified in a reduced incidence of postoperative complications and a lower stoma rate. Further RCTs considering long-term outcomes and cost-effectiveness analysis are needed.

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

2014 ◽  
Vol 22 (2) ◽  
pp. 497-504 ◽  
Author(s):  
Akihisa Matsuda ◽  
Masao Miyashita ◽  
Satoshi Matsumoto ◽  
Takeshi Matsutani ◽  
Nobuyuki Sakurazawa ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Large Bowel ◽  
Meta Analysis ◽  
Large Bowel Obstruction ◽  
Bridge To Surgery ◽  
Long Term Outcomes ◽  
Colonic Stent

Self-expanding Metallic Stents in Acute Mechanical Intestinal Obstructions Resulting from Colorectal Malignancies

2013 ◽  
Vol 79 (12) ◽  
pp. 1279-1282 ◽  
Author(s):  
Mehmet Karabulut ◽  
Koray Bas ◽  
Murat Gönenç ◽  
Mustafa Uygar Kalayci ◽  
Mehmet Abdussamet Bozkurt ◽  
...  
Keyword(s):  
Success Rate ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Patient Characteristics ◽  
Large Bowel Obstruction ◽  
Metallic Stents ◽  
Endoscopic Stenting ◽  
Bridge To Surgery ◽  
Effective Treatment Option ◽  
Colonic Stenting

Endoscopic colonic stenting with self-expanding metallic stents is now widely used to treat malignant large bowel obstruction, where temporary or permanent decompression of the large bowel is desired. The medical records of patients who underwent endoscopic colonic stenting for malignant large bowel obstruction between May 2004 and May 2011 were reviewed. Success rate, morbidity, and mortality rate along with patient characteristics were documented. Sixty-seven patients were included. The procedure was used as a bridge to surgery in 38 and as a palliative measure in 29. Success rate was 95.5 per cent. Perforation and reobstruction occurred in three and three patients, respectively. All of the patients who developed perforation or reobstruction underwent emergency surgery. Endoscopic stenting offers a safe and effective treatment option in patients with malignant large bowel obstruction with comparable outcomes.

A Clinical Evaluation of Endoscopicallyplaced Self-Expanding Metallic Stents in Patients with Acute Large Bowel Obstruction

2009 ◽  
Vol 98 (3) ◽  
pp. 143-147 ◽  
Author(s):  
H.-C. Pommergaard ◽  
P. Vilmann ◽  
H. L. Jakobsen ◽  
M. P. Achiam
Keyword(s):  
Mortality Rate ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Clinical Success ◽  
Large Bowel Obstruction ◽  
Metallic Stents ◽  
Safe Procedure ◽  
Bridge To Surgery ◽  
Mortality And Morbidity

Background and Aims: Self-expanding metallic stents (SEMS) have since 1991 established themselves as an option in the treatment of large bowel obstruction. The aim of this study was to evaluate the use of SEMS in management of acute colorectal obstructions at a Danish Surgical Gastroenterology center. Material and Methods: Retrospective review of charts from all patients who, in the period Marts 2002 to December 2007 underwent insertion of a SEMS for an acute large bowel obstruction. Results: Of 45 patients included, SEMS was intended as a bridge to surgery in 20 patients and as palliation in 25 patients. For malignant etiology, the SEMS procedure was a technical and clinical success in 97.4% of the cases. Complications occurred in 21%, mortality rate 2,6%. For benign etiology, the SEMS procedure was a technical success in 85.7%, and a clinical success in 71.4%. Complications occurred in 71.4% of the benign cases with a mortality rate of 28,6%. Conclusions: placement of SEMS for acute large bowel obstruction with malignant etiology is an effective and safe procedure with low mortality and morbidity. However results for benign obstructions are questionable and more research is needed to determine the role of SEMS.

Self-Expanding Metallic Stents for the Management of Emergency Malignant Large Bowel Obstruction: a Systematic Review

2015 ◽  
Vol 20 (2) ◽  
pp. 455-462 ◽  
Author(s):  
Yasoba Nayanapriya Atukorale ◽  
Jody Lynne Church ◽  
Benjamin Lee Hoggan ◽  
Robyn Sheree Lambert ◽  
Stefanie Lynette Gurgacz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Large Bowel Obstruction ◽  
Metallic Stents
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