Critical appraisal of oncological safety of stent as bridge to surgery in left-sided obstructing colon cancer; a systematic review and meta-analysis

被引：75

作者：

Amelung, Femke J. ^{[1
]}

Burghgraef, Thijs A. ^{[1
]}

Tanis, Pieter J. ^{[2
]}

van Hooft, Jeanin E. ^{[3
]}

ter Borg, Frank ^{[4
]}

Siersema, Peter D. ^{[5
]}

Bemelman, Willem A. ^{[2
]}

Consten, Esther C. J. ^{[1
]}

机构：

[1] Meander Med Ctr, Dept Surg, Maatweg 3, NL-3813 TZ Amersfoort, Netherlands

[2] Acad Med Ctr, Dept Surg, Meiberglaan 9, NL-1105 AZ Amsterdam, Netherlands

[3] Acad Med Ctr, Dept Gastroenterol & Hepatol, Meiberglaan 9, NL-1105 AZ Amsterdam, Netherlands

[4] Deventer Hosp, Dept Gastroenterol & Hepatol, Nico Bolkesteinlaan 75, NL-7416 SE Deventer, Netherlands

[5] Radboud Acad Med Ctr, Dept Gastroenterol & Hepatol, NL-6525 GA Nijmegen, Netherlands

来源：

CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY | 2018年 / 131卷

关键词：

Colon cancer; Colonic obstruction; Stent; SEMS; Emergency surgery; Survival; LONG-TERM OUTCOMES; EXPANDING METALLIC STENTS; LARGE-BOWEL OBSTRUCTION; MALIGNANT COLORECTAL OBSTRUCTION; EMERGENCY-SURGERY; LAPAROSCOPIC APPROACH; ELECTIVE SURGERY; MANAGEMENT; PLACEMENT; PERFORATION;

D O I：

10.1016/j.critrevonc.2018.08.003

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

This meta-analysis aims to determine the long-term oncological outcomes of SEMS as bridge to surgery (BTS) versus emergency surgery (ES). A systematic search without restrictions was conducted, and all studies comparing SEMS with ES reporting on long-term outcomes were included. Methodological quality was assessed using the appropriate tools. Twenty-one comparative studies were selected, reporting on 1919 patients. Meta-analysis showed no significant difference regarding three- and five-year overall survival (OR = 0-85 (0.68-1-08) and OR = 1.04 (0.68-1.57), respectively), disease-free survival (OR = 0.96 (0.73-1.26) and OR = 0.86 (0.54-1-36), respectively) and local recurrence rate (OR = 1.32 (0.78-2.23)). Permanent stomas were significantly lower in the SEMS group (OR 0.49 (0-32-0-74)). Sensitivity analysis on three-year survival showed opposite outcomes, with a trend towards worse survival in the SEMS group when only RCTs are taken into account. In conclusion, when in experienced hands, SEMS placement as BTS seems oncologically safe.

引用

页码：66 / 75

页数：10

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