Details

Autor(en) / Beteiligte

• Matsuda, Akihisa
• Yamada, Takeshi
• Yokoyama, Yasuyuki
• Takahashi, Goro
• Yoshida, Hiroshi

Titel

Long‐term outcomes between self‐expandable metallic stent and transanal decompression tube for malignant large bowel obstruction: A multicenter retrospective study and meta‐analysis

Ist Teil von

• Annals of gastroenterological surgery, 2023-07, Vol.7 (4), p.583-593

Ort / Verlag

Japan: John Wiley and Sons Inc

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Wiley Online Library Journals Frontfile Complete

Beschreibungen/Notizen

• Aim To compare the oncological outcomes between self‐expandable metallic stent (SEMS) as a bridge to surgery and transanal decompression tube (TDT) placement for malignant large bowel obstruction (MLBO). Methods A total of 287 MLBO patients who underwent SEMS (n = 137) or TDT placement (n = 150) were enrolled in this multicenter retrospective study. Overall survival (OS) and disease‐free survival (DFS) between the two groups were compared. A meta‐analysis was performed using random‐effects models to calculate odd ratios (OR) with 95% confidence intervals (CIs). Results Postoperative complications of Clavien–Dindo grade ≥II and ≥III occurred frequently in the TDT group compared with the SEMS group (P = 0.002 and 0.005, respectively). The 3‐y OS in the overall cohort and 3‐y DFS in the pathological stage II/III cohort in the SEMS and TDT groups were 68.6% and 71.4%, and 71.0% and 72.6%, respectively. The survival differences were not significantly different in the OS and DFS analyses (P = 0.819 and P = 0.892, respectively). A meta‐analysis of nine studies (including our cohort data) demonstrated no significant difference between the SEMS and TDT groups for 3‐y OS and DFS (OR = 0.96, 95% CI = 0.57–1.62, P = 0.89 and OR = 0.69, 95% CI = 0.46–1.04, P = 0.07, respectively). Conclusion Our study demonstrated that SEMS placement had no inferiority regarding long‐term outcomes, including OS and DFS, compared with TDT placement. Considering the short‐term benefits of SEMS placement, this could be a preferable preoperative decompression method for MLBO. Our study demonstrated that self‐expandable metallic stent (SEMS) placement had no inferiority regarding long‐term outcomes compared with transanal decompression tube placement. Considering the short‐term benefits of SEMS placement, this could be a preferable preoperative decompression method for malignant large bowel obstruction.