| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Tan, Ling Liu, Zi-lin Ran, Meng-ni Tang, Ling-han Pu, Yan-jun Liu, Yi-lei Ma, Zhou He, Zhou Xiao, Jiang-wei |
| Abstract | Background There is controversy regarding the efficacy of different treatment strategies for acute left malignant colonic obstruction. This study investigated the 5-year overall survival (OS) and disease-free survival (DFS) of several treatment strategies for acute left malignant colonic obstruction. Methods We searched for articles published in PubMed, Embase (Ovid), MEDLINE (Ovid), Web of Science, and Cochrane Library between January 1, 2000, and July 1, 2020. We screened out the literature comparing different treatment strategies. Evaluate the primary and secondary outcomes of different treatment strategies. The network meta-analysis summarizes the hazard ratio, odds ratio, mean difference, and its 95% confidence interval. Results The network meta-analysis involved 48 articles, including 8 (randomized controlled trials) RCTs and 40 non-RCTs. Primary outcomes: the 5-year overall survival (OS) and disease-free survival (DFS) of the CS-BTS strategy and the DS-BTS strategy were significantly better than those of the ES strategy, and the 5-year OS of the DS-BTS strategy was significantly better than that of CS-BTS. The long-term survival of TCT-BTS was not significantly different from those of CS-BTS and ES. Secondary outcomes: compared with emergency resection (ER) strategies, colonic stent-bridge to surgery (CS-BTS) and transanal colorectal tube-bridge to surgery (TCT-BTS) strategies can significantly increase the primary anastomosis rate, CS-BTS and decompressing stoma-bridge to surgery (DS-BTS) strategies can significantly reduce mortality, and CS-BTS strategies can significantly reduce the permanent stoma rate. The hospital stay of DS-BTS is significantly longer than that of other strategies. There was no significant difference in the anastomotic leakage levels of several treatment strategies. Conclusion Comprehensive literature research, we find that CS-BTS and DS-BTS strategies can bring better 5-year OS and DFS than ER. DS-BTS strategies have a better 5-year OS than CS-BTS strategies. Without considering the hospital stays, DS-BTS strategy is the best choice. |
| Related Links | https://wjes.biomedcentral.com/counter/pdf/10.1186/s13017-021-00355-2.pdf |
| Ending Page | 11 |
| Page Count | 11 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 17497922 |
| DOI | 10.1186/s13017-021-00355-2 |
| Journal | World Journal of Emergency Surgery |
| Issue Number | 1 |
| Volume Number | 16 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2021-03-18 |
| Access Restriction | Open |
| Subject Keyword | Emergency Medicine Traumatic Surgery Colonic stenting Transanal colorectal tube Decompressing stoma Bridge to surgery Emergency resection Acute left malignant colonic obstruction Network meta-analysis |
| Content Type | Text |
| Resource Type | Article |
| Subject | Surgery Emergency Medicine |
| Journal Impact Factor | 6/2023 |
| 5-Year Journal Impact Factor | 7.3/2023 |
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