Evidence map›Paper›PMID 28409374›Full record

ArticleSurgical endoscopy2017

Self-expandable metal stent placement versus emergency resection for malignant proximal colon obstructions.

Femke Julie Amelung, Werner Adriaan Draaisma, Esther Catharina Josephina Consten, Peter Derk Siersema, Frank Ter Borg

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In one paragraph

Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  14. Outcomes of colon self-expandable metal stents for malignantWorld journal of gastrointestinal endoscopy · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Femke Julie AmelungDepartment of Surgery, Meander Medical Center, Maatweg 3, 3813TZ, Amersfoort, the Netherlands.
Werner Adriaan DraaismaDepartment of Surgery, Meander Medical Center, Maatweg 3, 3813TZ, Amersfoort, the Netherlands. wa.draaisma@meandermc.nl.
Esther Catharina Josephina ConstenDepartment of Surgery, Meander Medical Center, Maatweg 3, 3813TZ, Amersfoort, the Netherlands.
Peter Derk SiersemaDepartment of Gastroenterology and Hepatology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
Frank Ter BorgDepartment of Gastroenterology and Hepatology, Deventer Hospital, Nico Bolkesteinlaan 75, 7416 SE, Deventer, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTraditionally, all patients with a malignant obstruction of the proximal colon (MOPC) are treated with emergency resection. However, recent data suggest that Self-expandable metallic stent (SEMS) placement could lower mortality and morbidity rates. This study therefore aimed to compare SEMS placement with emergency resection as treatment options for MOPC.

methodsAll consecutive patients that underwent SEMS placement for MOPC in the period 2004-2015 at our institution were identified. SEMS placement was the standard of care for colonic obstructions at our institution in that period. All included SEMS patients were matched (1:4) on age (±5 years), gender, ASA-score, tumor location, surgical approach and pTNM-stage with patients treated by emergency resection. Controls were selected from a national database that prospectively registers all patients undergoing surgery for colorectal cancer in the Netherlands.

resultsIn total, 41 patients received SEMS placement for MOPC. In 19 patients SEMS served as a definite palliative measure and in 22 as bridge to surgery. Technical and clinical success rates of SEMS placement were 92.7% and 90.2%, respectively. No significant differences between the SEMS and emergency resection group were found regarding morbidity and mortality rates, the number of radical resections and the number of primary anastomoses. Patients treated with SEMS were, however, less likely to have a temporary stoma constructed (p = 0.04). No SEMS-related complications occurred in patients in whom SEMS was placed as bridge to surgery, whereas one stent-related perforation, three stent migrations, and five stent re-obstructions were observed in the palliative group. Three re-obstructions could be treated with re-stenting, but all other SEMS-related complications required surgical intervention. In the palliative group, SEMS complications necessitating surgery occurred in 31.6% of the patients (6/19).

conclusionSEMS placement for MOPC appears to be a relatively feasible and safe alternative for emergency resection in both the curative and palliative setting.

Indexed as

AdultAgedAged, 80 and overCase-Control StudiesColectomyColonColonic NeoplasmsFemaleHumansIntestinal ObstructionMaleMiddle AgedNetherlandsRegistriesSelf Expandable Metallic StentsSurvival AnalysisColon cancerColon obstructionEmergency resectionSelf-expandable metal stent (SEMS)Stent

Identifiers

PMID28409374

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.