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Role of self-expanding metal stents in patients with malignant colorectal obstruction: A systematic review and meta-analysis

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World Journal of Meta-Analysis 2015年第6期3卷 232-253页

作者： Nirav Thosani Subhas Banerjee vikesh khanijow Bhavana Rao Priyanka Priyanka Atilla Ertan Sushovan Guha Division of Gastroenterology and Hepatology Stanford University School of Medicine Division of Gastroen- terology Hepatology and Nutrition Department of Internal Medicine the University of Texas Health Medical School at Houston Ertan Digestive Disease Center Memorial Hermann Hospital--TMC

AIM: To assess the safety and efficacy of self-expandable metal stents(SEMSs) for malignant colorectal obstruction. METHODS: Data regarding technical success, clinical success, and procedure related complications were collected from included studies. Der Simonian-Laird random effects model was used to generate the overall outcome. Thirty international studies with a total of 2058 patients with malignant colorectal obstruction were included. RESULTS: The technical and clinical success rates for SEMS placement were 94%(95%CI: 92-96) and 91%(95%CI: 88-93), respectively. Overall complication rate for SEMS was 23%(95%CI: 18-29). Stent migration8%(95%CI: 6-10) and stent obstruction 8%(95%CI: 6-11) were the most common complications, followed by perforation 5%(95%CI: 4%-7%). Surgical or endoscopic re-interventions were needed in 14%(95%CI: 10-18) of patients. Endoscopic repeat stent placement was required in 8%(95%CI: 6-10), while surgical intervention was needed in 6%(95%CI: 4-8).CONCLUSION: SEMS are effective when used as palliation or bridge to surgery for malignant colorectal obstruction with high technical and clinical success. About 14% of patients require repeat endoscopic or surgical intervention for stent failure or to manage stent related complications.

关键词： Metal stent Colorectal cancer Colon cancer Rectal cancer Intestinal obstruction Bowel obstruction Malignant obstruction Colonic obstruction

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