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Comparison of efficacy between uncovered and covered self-expanding metallic stents in malignant large bowel obstruction: a systematic review and meta-analysis.
MedLine Citation:
PMID:  22540666     Owner:  NLM     Status:  Publisher    
Aim:  Insertion of a self-expandable metallic stent (SEMS) can rapidly relieve colorectal obstruction. This study aimed to compare the efficacy between uncovered and covered SEMS in the treatment of malignant colorectal obstruction. Method:  A systematic search in Medline, Embase, the Cochrane controlled trials register and bibliographies of retrieved articles was performed. Randomized controlled trials (RCT) and other comparative studies comparing uncovered stents and covered SEMS for treatment of malignant colorectal obstruction were selected for this systematic review and meta-analysis. The main outcome measures were technical success, clinical success, tumour ingrowth, tumour overgrowth, early migration (≤ 7 days), late migration (> 7days), overall complications, and the duration of stent patency. Results:  Compared with covered SEMS, uncovered SEMS were associated with a lower late migration rate (relative risk [RR], 0.25; 95% confidence interval [CI], 0.08, 0.80; p = 0.02), a higher tumour ingrowth rate (RR, 5.99; 95% CI, 2.23, 16.10; p = 0.0004), and a prolonged stent patency (weighted mean difference [WMD], 15.34 days; 95% CI, 4.31, 26.37; p = 0.006). There was no significant difference in technical success, clinical success, tumour overgrowth, early migration, perforation, or overall complications between the two groups. Conclusion:  Tumour ingrowth occurred more frequently in the uncovered SEMS group, while late migration was more common in the covered SEMS group. © 2012 The Authors Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.
Y Zhang; J Shi; B Shi; C Y Song; W F Xie; Y X Chen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-27
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  -     ISSN:  1463-1318     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.
Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
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