医学
荟萃分析
优势比
置信区间
外科
肝病学
腹部外科
肠梗阻
结直肠癌
支架
肠切除术
内窥镜支架置入术
内科学
癌症
作者
Shintaro Kanaka,Akihisa Matsuda,Takeshi Yamada,Ryo Ohta,Hiromichi Sonoda,Seiichi Shinji,Goro Takahashi,Takuma Iwai,Kohki Takeda,Koji Ueda,Satoru Kuriyama,Toshimitsu Miyasaka,Hiroshi Yoshida
标识
DOI:10.1007/s00464-022-09071-7
摘要
BackgroundPreoperative colonic stenting for malignant large bowel obstruction (MLBO), also called bridge to surgery (BTS), is considered a great substitute treatment for emergency resection (ER) in the left-sided colon. However, its efficacy in the right-sided colon remains controversial. This systematic review and meta-analysis aimed to compare the postoperative short-term outcomes between BTS and ER for right-sided MLBO.MethodsA comprehensive electronic literature search throughout December 2020 was performed to identify studies comparing short-term outcomes between BTS and ER for right-side MLBO. The main outcome measures were postoperative complications and mortality rates. A meta-analysis was performed using a fixed-effect or a random-effect method to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs).ResultsSeven studies were included in this meta-analysis, comprising 5136 patients, of whom 1662 (32.4%) underwent BTS and 3474 (67.6%) underwent ER. This meta-analysis demonstrated that BTS resulted in reductions in postoperative complications (OR = 0.78; 95% CI: 0.66–0.92) and mortality (OR = 0.51; 95% CI: 0.28–0.92) than ER.ConclusionThe results of this meta-analysis indicate that BTS for right-sided MLBO confers preferable short-term outcomes as well as for left-sided. This suggests that BTS results in a reduction of postoperative complications and mortality for right-sided MLBO than ER.
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