Research Article

Fluoroscopic Stenting as a Bridge to Surgery versus Emergency Management for Malignant Obstruction of the Colon

Table 4

Systematic reviews and meta-analyses on the topic of the SEMS as a bridge to surgery versus emergency surgery for malignant large bowel obstruction.

ReferencesStudy typeStudy reviewed (number)Population (SEMS : ES)ObjectTechnical/clinical success rate (%)Findings
Significant differenceNo significant difference

Tan et al. [4]Meta-analysisRCT (4)234 (116 : 118)Left colon70.7/69.0SEMS: lower overall stoma rate, higher successful primary anastomosis ratePostoperative mortality, primary anastomosis rate, permanent stoma rate, anastomotic leak rate, surgical site infection rate, 30-day reoperation rate

Ye et al. [16]Meta-analysisRCT (3), RS (5)444 (219 : 225)Left colonNASEMS: lower overall postoperative morbidity, lower temporary stoma ratePostoperative mortality, permanent stoma rate, anastomotic leak rate, occurrence of abscesses rate, abdominal complications rate

Zhang et al. [17]Meta-analysisRCT (2), RS (6)601 (232 : 369)Colon and rectum87.1/NASEMS: lower overall postoperative morbidity, lower overall stoma rate, higher primary anastomosis rate, lower anastomotic leakage rate, lower intensive care ratePostoperative mortality, permanent stoma rate, overall survival

Cirocchi et al. [18]Meta-analysisRCT (3)197 (97 : 100)Left colon and rectum62.9/52.5SEMS: lower overall stoma rate, higher primary anastomosis rateOverall postoperative morbidity, postoperative mortality, permanent stoma rate, anastomotic leakage rate, intra-abdominal abscess rate, infections (wound, chest, urinary tract) rate

De Ceglie et al. [19]Meta-analysisRCT (5), RS (5), PS (3), CM (1)876 (405 : 471)Left colon96.9/94.2SEMS: lower overall stoma rate, higher primary anastomosis rate, higher successful primary anastomosis rate, lower infection ratePostoperative mortality, temporary stoma rate, anastomotic leakage rate, length of hospitalization, overall survival

Zhao et al. [20]Meta-analysisRCT (5)273 (136 : 137)Left colonNASEMS: lower overall postoperative morbidity, lower overall stoma rate, lower permanent stoma rate, lower surgical site infection ratePostoperative mortality, primary anastomosis rate, anastomotic leak rate

Huang et al. [21]Meta-analysisRCT (7)382 (195 : 187)Left colon76.9/NASEMS: lower overall postoperative morbidity, lower permanent stoma rate, higher primary anastomosis rate, lower wound infection ratePostoperative mortality, anastomotic leakage rate, intra-abdominal infection rate

Amelung et al. [22]Systematic reviewRS (10), PS (4)2992 (2837 : 155)Right colon95.5/89.0SEMS: lower postoperative mortality, lower major complication rateOverall postoperative morbidity, minor complication rate

Matsuda et al. [23]Meta-analysisRCT (2), RS (7), PS (2)1136 (432 : 704)ColonNANoneOverall survival, disease-free survival, recurrence rate

Arezzo et al. [24]Meta-analysisRCT (8)497 (251 : 246)Left colonNASEMS: lower overall postoperative morbidity, lower permanent stoma rate, lower temporary stoma rate, higher primary anastomosis ratePostoperative mortality

Wang et al. [25]Meta-analysisRCT (9)594 (281 : 313)Left colonNASEMS: lower postoperative mortality, lower minor complications rate, higher primary anastomosis rateAnastomotic leakage rate

Amelung et al. [26]Meta-analysisRCT (5), RS (12), PS (4)1919 (938 : 981)Left colonNASEMS: lower permanent stoma rateOverall survival, disease-free survival, recurrence rate

Foo et al. [27]Meta-analysisRCT (7)448 (222 : 226)Left colonNASEMS: lower overall postoperative morbidity, higher recurrence ratePostoperative mortality, overall survival, disease-free survival

Boland et al. [28]Systematic reviewRCT (7)408 (201 : 207)Left colon and rectum81.1/76.1NANA

Cao et al. [29]Meta-analysisRCT (5), RS (16), PS (3)2580 (1302 : 1278)Colon and rectumNANone3-year survival, 5-year survival, 3-year disease-free survival, 5-year disease-free survival, local recurrence rate, overall recurrence rate

RCT, randomized clinical trial; RS, retrospective study; PS, prospective study; CM, case-matched; NA, not available. Value expressed by mean. Classified by Clavien–Dindo classification of surgical complications: minor morbidity was defined as grade IIIa or lower and major as grade IIIb or higher.