Self-expandable metal stent (SEMS) placement or emergency surgery as palliative treatment for obstructive colorectal cancer: A systematic review and meta-analysis

被引：23

作者：

Veld, Joyce ^{[1
,2
]}

Umans, Devica ^{[1
]}

van Halsema, Emo ^{[1
]}

Amelung, Femke ^{[3
]}

Fernandes, Dalia ^{[4
]}

Lee, Mei Sze ^{[5
]}

Stupart, Douglas ^{[6
]}

Suarez, Javier ^{[7
]}

Tomiki, Yuichi ^{[8
]}

Bemelman, Willem ^{[2
]}

Fockens, Paul ^{[1
]}

Consten, Esther ^{[9
,10
]}

Tanis, Pieter ^{[2
]}

van Hooft, Jeanin ^{[1
,11
]}

机构：

[1] Univ Amsterdam, Canc Ctr Amsterdam, Dept Gastroenterol & Hepatol, Amsterdam UMC, Amsterdam, Netherlands

[2] Univ Amsterdam, Canc Ctr Amsterdam, Dept Surg, Amsterdam UMC, Amsterdam, Netherlands

[3] Jeroen Bosch Hosp, Dept Surg, Shertogenbosch, Netherlands

[4] Hosp Braga, Dept Gastroenterol, Braga, Portugal

[5] Christchurch Hosp, Gen Surg Dept, Christchurch, New Zealand

[6] Deakin Univ, Dept Surg, Geelong, Vic 3220, Australia

[7] Complejo Hosp Navarra, Gen Surg Dept, Colorectal Unit, Pamplona, Spain

[8] Juntendo Univ, Dept Coloproctol Surg, Fac Med, Tokyo, Japan

[9] Meander Med Ctr, Dept Surg, Amersfoort, Netherlands

[10] Univ Med Ctr Groningen, Dept Surg, Groningen, Netherlands

[11] Leiden Univ, Dept Gastroenterol & Hepatol, Med Ctr, Leiden, Netherlands

来源：

CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY | 2020年 / 155卷

关键词：

Obstructive colorectal cancer; Self-Expandable metal stent; Emergency surgery; Palliation; MALIGNANT COLONIC OBSTRUCTION; LONG-TERM OUTCOMES; PRIMARY TUMOR; ENDOSCOPIC STENT; RESECTION; COLOSTOMY; BIAS; CHEMOTHERAPY; MANAGEMENT; BRIDGE;

D O I：

10.1016/j.critrevonc.2020.103110

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Previous meta-analyses on palliative treatment of malignant colorectal obstruction with Self-Expandable Metal Stent (SEMS) or emergency surgery reported contradictory results for morbidity, and frequently included extracolonic obstruction. Therefore, the current meta-analysis aimed to exclusively analyze palliative treatment for primary obstructive colorectal cancer, with early complication rate as a primary outcome. A systematic literature search was performed on studies comparing palliative SEMS and emergency surgery. Corresponding authors were contacted for additional data. Eighteen studies were selected (1518 patients). Early complication rate was 13.6 % for SEMS and 25.5 % for emergency surgery (Odds Ratio (OR) 0.46, 95 % confidence interval (CI) 0.29-0.74). Mortality was 3.9 % and 9.4 % (OR 0.44, 0.28-0.69). Stomas were present in 14.3 % and 51.4 % of patients (OR 0.17, 0.09-0.31). More late complications occurred after SEMS (23.2 % versus 9.8 %, OR 2.55, 1.70-3.83), mostly due to SEMS obstruction. In conclusion, SEMS placement seems the preferred treatment of obstructing colorectal cancer in the palliative setting.

引用

页数：12

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