Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026
Is there a preferred management option for malignant large bowel obstruction secondary to colorectal cancer: A systematic review and meta-analysis between colonic stents as a bridge to surgery versus emergency surgery?
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Liew Amos Nepacina, Tan Raelene Yi Mei, Lim Wei Mou, Arachchi Asiri, Saranasuriya Chaminda, Suhardja Thomas Surya, Narasimhan Vignesh, Lim James, Teoh William, Chouhan Hanumant, Tay Yeng Kwang, Nguyen Thang Chien
Аннотация
AIM: To compare peri-operative and oncological outcomes between self-expanding metal stents as a bridge-to-surgery (SEM-BTS) and emergency surgery for malignant large bowel obstruction (MLBO) secondary to colorectal cancer.
METHOD: This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD420251114887). A comprehensive search of PubMed, OVID Medline and Embase identified English-language studies from January 2000 to June 2025. Both randomised and observational comparative studies were included. Outcomes analysed included rates of primary anastomosis, stoma formation, peri-operative complications and long-term oncological endpoints.
RESULTS: Twenty-four studies (N = 3449; 7 RCTs and 17 observational) met inclusion criteria. SEM-BTS was associated with higher rates of primary anastomosis (OR 2.81, 95% CI 1.98-3.99), lower stoma formation (OR 0.29, 95% CI 0.20-0.41) and greater use of laparoscopic surgery (OR 5.13, 95% CI 1.67-15.79). There were no significant differences in anastomotic leak, post-operative mortality, recurrence or 5-year overall survival.
CONCLUSION: SEM-BTS provides superior short-term surgical outcomes without compromising oncological safety when applied in appropriately selected patients with centres with experienced endoscopists. While stent-related complications remain a concern, SEM-BTS may be considered a viable alternative to emergency surgery for left-sided MLBO.
METHOD: This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD420251114887). A comprehensive search of PubMed, OVID Medline and Embase identified English-language studies from January 2000 to June 2025. Both randomised and observational comparative studies were included. Outcomes analysed included rates of primary anastomosis, stoma formation, peri-operative complications and long-term oncological endpoints.
RESULTS: Twenty-four studies (N = 3449; 7 RCTs and 17 observational) met inclusion criteria. SEM-BTS was associated with higher rates of primary anastomosis (OR 2.81, 95% CI 1.98-3.99), lower stoma formation (OR 0.29, 95% CI 0.20-0.41) and greater use of laparoscopic surgery (OR 5.13, 95% CI 1.67-15.79). There were no significant differences in anastomotic leak, post-operative mortality, recurrence or 5-year overall survival.
CONCLUSION: SEM-BTS provides superior short-term surgical outcomes without compromising oncological safety when applied in appropriately selected patients with centres with experienced endoscopists. While stent-related complications remain a concern, SEM-BTS may be considered a viable alternative to emergency surgery for left-sided MLBO.