AI Article Synopsis
- The study aimed to compare the safety and effectiveness of self-expanding metallic stents (SEMS) as a pre-surgical bridge versus emergency surgery for patients with left-sided malignant colorectal obstruction.
- A thorough literature search identified 14 studies with 1,083 patients, and a meta-analysis was conducted to analyze the outcomes of both methods.
- Results showed that SEMS led to lower short-term mortality and overall complications, higher resection rates, shorter operation times, and quicker recovery, indicating it is a safer and more effective option than emergency surgery.
Article Abstract
Objective: 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.
Methods: 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.
Results: 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% CI:0.30-0.93, P<0.05), lower overall complications(RR=0.46, 95% CI:0.31-0.70, P<0.05), higher resection rate(RR=1.90, 95%CI:1.33-2.70, 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.
Conclusion: The safety and efficacy of self-expending metallic stents as bridge to surgery for left-sided malignant colorectal obstruction is superior to emergency surgery.
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