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Journal of Gastrointestinal Surgery
Erschienen in: Journal of Gastrointestinal Surgery 2/2016

01.02.2016 | Review Article

Self-Expanding Metallic Stents for the Management of Emergency Malignant Large Bowel Obstruction: a Systematic Review

verfasst von: Yasoba Nayanapriya Atukorale, Jody Lynne Church, Benjamin Lee Hoggan, Robyn Sheree Lambert, Stefanie Lynette Gurgacz, Stephen Goodall, Guy J. Maddern

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 2/2016

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Abstract

Objectives

This paper evaluates the safety and effectiveness of self-expanding metallic stents (SEMS) for the management of emergency malignant colorectal obstruction in patients otherwise requiring multi-stage surgery. No systematic review has been conducted comparing SEMS to only multi-stage surgery.

Methods

Bibliographic databases, including Cochrane, PubMed, EMBASE, and CINAHL, were searched in September 2011 and repeated in November 2013. A pre-determined protocol outlined the study inclusion and appraisal.

Results

Forty articles were included, seven compared SEMS to multi-stage surgery. Included studies were of low to moderate quality. Bowel perforation was the most severe stent-related complication, while tumor- and stent-related events occurred most frequently. No significant differences in rates of obstruction relief were reported between treatments, and results regarding relative quality of life were inconclusive. SEMS recipients progressed to elective surgery sooner and required shorter post-procedural hospital stays, but commonly required re-intervention. SEMS provided enduring palliative relief of obstruction, with comparable survival longevity between treatments.

Conclusion

SEMS placement is a viable alternative to multi-stage surgery, providing patients with benefits as a bridge-to-surgery and relief of obstruction in a palliative context, with minimal differences in clinical success and safety compared to multi-stage surgery.
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Metadaten
Titel
Self-Expanding Metallic Stents for the Management of Emergency Malignant Large Bowel Obstruction: a Systematic Review
verfasst von
Yasoba Nayanapriya Atukorale
Jody Lynne Church
Benjamin Lee Hoggan
Robyn Sheree Lambert
Stefanie Lynette Gurgacz
Stephen Goodall
Guy J. Maddern
Publikationsdatum
01.02.2016
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 2/2016
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-015-2997-7

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