Ricardo Frago1, Elena Ramirez1, Monica Millan1, Esther Kreisler1, Emilio del Valle2, Sebastiano Biondo3. 1. Department of General and Digestive Surgery, Colorectal Unit, Bellvitge University Hospital, University of Barcelona, and IDIBELL, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain. 2. Department of Surgery, Colorectal Unit, Gregorio Marañon General University Hospital, Madrid, Spain. 3. Department of General and Digestive Surgery, Colorectal Unit, Bellvitge University Hospital, University of Barcelona, and IDIBELL, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain. Electronic address: sbn.biondo@gmail.com.
Abstract
BACKGROUND: The management of colonic obstruction has changed in recent years. In distal obstruction, optimal treatment remains controversial, particularly after the appearance and use of colonic endoluminal stents. The purpose of this study was to review the current treatment of acute malignant large bowel obstruction according to the level of evidence of the available literature. METHODS: A systematic search was conducted in PubMed, MEDLINE, Embase, and Google Scholar for articles published through January 2013 to identify studies of large bowel obstruction and colorectal cancer. Included studies were randomized and nonrandomized controlled trials, reviews, systematic reviews, and meta-analysis. RESULTS: After a literature search of 1,768 titles and abstracts, 218 were selected for full-text assessment; 59 studies were ultimately included. Twenty-five studies of the diagnosis and treatment of obstruction and 34 studies of the use of stents were assessed. CONCLUSIONS: In view of the various alternatives and the lack of high-grade evidence, the treatment of distal colonic obstruction should be individually tailored to each patient.
BACKGROUND: The management of colonic obstruction has changed in recent years. In distal obstruction, optimal treatment remains controversial, particularly after the appearance and use of colonic endoluminal stents. The purpose of this study was to review the current treatment of acute malignant large bowel obstruction according to the level of evidence of the available literature. METHODS: A systematic search was conducted in PubMed, MEDLINE, Embase, and Google Scholar for articles published through January 2013 to identify studies of large bowel obstruction and colorectal cancer. Included studies were randomized and nonrandomized controlled trials, reviews, systematic reviews, and meta-analysis. RESULTS: After a literature search of 1,768 titles and abstracts, 218 were selected for full-text assessment; 59 studies were ultimately included. Twenty-five studies of the diagnosis and treatment of obstruction and 34 studies of the use of stents were assessed. CONCLUSIONS: In view of the various alternatives and the lack of high-grade evidence, the treatment of distal colonic obstruction should be individually tailored to each patient.
Authors: M W van den Berg; M Ledeboer; M G W Dijkgraaf; P Fockens; F ter Borg; J E van Hooft Journal: Surg Endosc Date: 2014-10-08 Impact factor: 4.584