Abstract
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.
Original language | English |
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Pages (from-to) | 66-75 |
Number of pages | 10 |
Journal | Critical Reviews in Oncology/Hematology |
Volume | 131 |
DOIs | |
Publication status | Published - Nov-2018 |
Externally published | Yes |
Keywords
- 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