Affiliation:
1. Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery Nippon Medical School Tokyo Japan
2. Department of Surgery Nippon Medical School Chiba Hokusoh Hospital Chiba Japan
3. Department of Digestive Surgery Nippon Medical School Musashikosugi Hospital Kawasaki Kanagawa Japan
Abstract
AbstractAimTo 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).MethodsA 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).ResultsPostoperative 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).ConclusionOur 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.
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3 articles.
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