Meta-analysis of complications of colonic stenting versus emergency surgery for acute left-sided malignant colonic obstruction.
BACKGROUND
Left-sided malignant colonic obstruction is one of the most difficult clinical problems, whereas both emergency operations and colonic stenting may have their own advantages and disadvantages. The purpose of this study was to evaluate the complications of colonic stenting versus emergency surgery for acute left-sided malignant colonic obstruction.


METHODS
Medline, Embase, and the Cochrane Library were searched. Only prospective randomized controlled trials that compared the 2 methods were included. Evaluation indexes in our study involved hospital death rates and complications.


RESULTS
No significant difference in either hospital death rates or the overall complications between the 2 groups was found. Heterogeneity analysis found that there was no significant heterogeneity. Removing individual studies from the data editor did not substantially change the RR or the level of heterogeneity of significance for our 2 outcome measures. Testing for publication bias showed that hospital death rates and the overall complications had no serious publication bias.


CONCLUSIONS
Colonic stenting was no better than emergency surgery, and should be only used as an alternative to emergency surgery carefully.
Department of Colorectal Surgery, Gastrointestinal Institute of Sun Yat-Sen University, The Sixth Affiliated Hospital of Sun Yat-Sen University (Guangdong Gastrointestinal Hospital), Guangzhou, Guangdong, People's Republic of China.
Zhihua
Z
Liu
Liang
L
Kang
Chao
C
Li
Meijin
M
Huang
Xingwei
X
Zhang
Jianping
J
Wang
D003082:Colectomy / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D004630:Emergencies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome