PURPOSE: Surgical decompression is the traditional treatment for acute colorectal cancer obstruction. In recent years, colorectal stenting has been used to relieve the obstruction. This study used meta-analytic techniques to compare colonic stenting versus surgical decompression for colorectal cancer obstruction. METHODS: A comprehensive search of several databases was conducted. The search identified 321 potential abstracts and titles of which eight randomized trials involving 353 patients were retrieved in full text. A meta-analysis of the studies included was carried out to identify the differences in outcomes between the two procedures. RESULTS: The pooled analysis showed no significant differences for mortality (odds ratio (OR) 0.91) and morbidity (OR 2.05) rates between the two strategies while the permanent stoma creation rate was significantly higher in the surgical group as compared to the stent group (OR 3.12). By comparing surgery and colonic stenting in studies which analyzed the use of stenting as a "bridge to surgery," the pooled analysis showed that primary anastomosis was more frequent in the stent group as compared to the surgical group (OR 0.42), and the stoma creation was more frequent in the surgical group as compared to the stent group (OR 2.36). CONCLUSION: Our study suggested that, in patients with acute colorectal cancer obstruction, stent placement improved several outcomes, such as primary anastomosis, stoma formation, and permanent stoma, while it failed to show an improvement in mortality and morbidity risk.
PURPOSE: Surgical decompression is the traditional treatment for acute colorectal cancer obstruction. In recent years, colorectal stenting has been used to relieve the obstruction. This study used meta-analytic techniques to compare colonic stenting versus surgical decompression for colorectal cancer obstruction. METHODS: A comprehensive search of several databases was conducted. The search identified 321 potential abstracts and titles of which eight randomized trials involving 353 patients were retrieved in full text. A meta-analysis of the studies included was carried out to identify the differences in outcomes between the two procedures. RESULTS: The pooled analysis showed no significant differences for mortality (odds ratio (OR) 0.91) and morbidity (OR 2.05) rates between the two strategies while the permanent stoma creation rate was significantly higher in the surgical group as compared to the stent group (OR 3.12). By comparing surgery and colonic stenting in studies which analyzed the use of stenting as a "bridge to surgery," the pooled analysis showed that primary anastomosis was more frequent in the stent group as compared to the surgical group (OR 0.42), and the stoma creation was more frequent in the surgical group as compared to the stent group (OR 2.36). CONCLUSION: Our study suggested that, in patients with acute colorectal cancer obstruction, stent placement improved several outcomes, such as primary anastomosis, stoma formation, and permanent stoma, while it failed to show an improvement in mortality and morbidity risk.
Authors: Alberto Arezzo; Carmen Balague; Eduardo Targarona; Felice Borghi; Giorgio Giraudo; Luigi Ghezzo; Antonio Arroyo; Javier Sola-Vera; Paolo De Paolis; Maurizio Bossotti; Elisa Bannone; Edoardo Forcignanò; Marco Augusto Bonino; Roberto Passera; Mario Morino Journal: Surg Endosc Date: 2016-12-06 Impact factor: 4.584
Authors: Hyun Jung Lee; Soo Jung Park; Jae Hee Cheon; Tae Il Kim; Won Ho Kim; Sung Pil Hong Journal: Int J Colorectal Dis Date: 2014-11-08 Impact factor: 2.571
Authors: Philip N Okafor; Derrick J Stobaugh; Louis M Wong Kee Song; Paul J Limburg; Jayant A Talwalkar Journal: Dig Dis Sci Date: 2016-01-06 Impact factor: 3.199
Authors: Chi Chung Foo; Samuel Ho Ting Poon; Rosemaire Hon Yiu Chiu; Wai Yiu Lam; Lam Chi Cheung; Wai Lun Law Journal: Surg Endosc Date: 2018-10-19 Impact factor: 4.584