دورية أكاديمية
The use of self-expanding metallic stents in the management of benign colonic obstruction: a systematic review and meta-analysis.
العنوان: | The use of self-expanding metallic stents in the management of benign colonic obstruction: a systematic review and meta-analysis. |
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المؤلفون: | Fardanesh A; Department of General Surgery, Royal London Hospital, Bart's Health NHS Foundation Trust, London, England, UK., George J; Department of General Surgery, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Sheffield, England, UK. jayan.george@aol.com.; Division of Clinical Medicine, University of Sheffield, Sheffield, England, UK. jayan.george@aol.com., Hughes D; Department of UGI Surgery, Royal Berkshire NHS Foundation Trust, Reading, England, UK., Stavropoulou-Tatla S; Department of Plastic Surgery, St George's University Hospitals NHS Foundation Trust, London, England, UK., Mathur P; Department of General Surgery, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, England, UK. |
المصدر: | Techniques in coloproctology [Tech Coloproctol] 2024 Jul 19; Vol. 28 (1), pp. 85. Date of Electronic Publication: 2024 Jul 19. |
نوع المنشور: | Systematic Review; Journal Article; Meta-Analysis |
اللغة: | English |
بيانات الدورية: | Publisher: Springer-Verlag Italia Country of Publication: Italy NLM ID: 9613614 Publication Model: Electronic Cited Medium: Internet ISSN: 1128-045X (Electronic) Linking ISSN: 11236337 NLM ISO Abbreviation: Tech Coloproctol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: <2001->: Milano, Italy : Springer-Verlag Italia Original Publication: Rome : UCP Club, |
مواضيع طبية MeSH: | Intestinal Obstruction*/etiology , Intestinal Obstruction*/surgery , Self Expandable Metallic Stents* , Colonic Diseases*/surgery , Colonic Diseases*/etiology, Humans ; Female ; Male ; Treatment Outcome ; Aged ; Middle Aged |
مستخلص: | Introduction: Patients presenting with large bowel obstruction (LBO) frequently undergo emergency surgery that is associated with significant morbidity. In malignant LBO, endoscopic approaches with placement is a self-expanding metal stent (SEMS), have been proposed to prevent emergency surgery and act as a bridge to an elective procedure-with the intention of avoiding a stoma and reducing morbidity. This systematic review aims to assess the quality and outcomes of data available on the use of SEMS in benign causes of colonic obstruction. Methods: This systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the protocol was registered on Prospero (ID: CRD42021239363). PUBMED, MEDLINE, HMIC, CINAHL, AMED, EMBASE, APA and Cochrane databases were searched. Studies were assessed for quality utilising the MINORS criteria. Pooled odds ratios with 95% confidence intervals (95% CI) were calculated using random effects models. Results: Sixteen studies were included for analysis. 300 patients were included with an average age of 68, and a male predominance of 57%. The quality of the papers included were at risk of bias. The pooled rate of technical success of procedure was 94.4% (95% CI 90.5-96.8%) The pooled rate of clinical success was 77.6% (95% CI: 66.6-85.7%). Adverse effects were low, with perforation 8.8% (4.5-16.6%), recurrence 26.5% (17.2-38.5%) and stent migration 22.5% (14.1-33.8%). Discussion: This systematic review demonstrated that SEMS for benign colonic obstruction can be a safe and successful procedure. The utilisation of SEMS in malignant disease as a bridge to surgery has been well documented. Whilst the limitations of the data interpreted are appreciated, we postulate that SEMS could be utilised to decompress patients acutely and allow pre-operative optimisation, leading to a more elective surgery with less subsequent morbidity. (© 2024. The Author(s).) |
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فهرسة مساهمة: | Keywords: Benign; Benign colonic obstruction; Large bowel obstruction; Meta-analysis; Self-expanding metal stents; Stenting |
تواريخ الأحداث: | Date Created: 20240719 Date Completed: 20240719 Latest Revision: 20240727 |
رمز التحديث: | 20240727 |
مُعرف محوري في PubMed: | PMC11271435 |
DOI: | 10.1007/s10151-024-02959-7 |
PMID: | 39028327 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1128-045X |
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DOI: | 10.1007/s10151-024-02959-7 |