Evidence map›Paper›PMID 33302923›Full record

ArticleBMC surgery2020

Self-expandable metallic stenting as a bridge to elective surgery versus emergency surgery for acute malignant right-sided colorectal obstruction.

Bing Li, Shi-Lun Cai, Zhen-Tao Lv, Ping-Hong Zhou, Li-Qing Yao, Qiang Shi, Zhi-Peng Qi, Di Sun, Ayimukedisi Yalikong, En-Pan Xu and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 5 pooled it
0.9field-weighted citation impact, top 22% of its field
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, 5 syntheses or guidelines pooled it, 18 citations in OpenAlex.

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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

12 authors at 2 institutions in 1 country.

Bing LiEndoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Shi-Lun CaiEndoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Zhen-Tao LvEndoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Ping-Hong ZhouEndoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Li-Qing YaoEndoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Qiang ShiEndoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Zhi-Peng QiEndoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Di SunEndoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Ayimukedisi YalikongEndoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
En-Pan XuEndoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Jian-Min XuDepartment of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Yun-Shi ZhongEndoscopy Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, China. zhongyunshi@yahoo.com.ORCID http://orcid.org/0000-0002-3128-3168
Fudan University · CNSun Yat-sen University · CN

Funding

the Dawn Program of the Shanghai Education Commission 18SG08the National Natural Science Foundation of China 81672329
6 · The paper itself

Abstract

backgroundThe use of a self-expandable metallic stent (SEMS) as a bridge to surgery has increased for patients with obstructing colorectal cancer. However, relatively few reports have compared SEMS as a bridge to elective surgery for acute malignant obstruction of the right-sided colon (MORC) vs. emergency surgery (ES). This study aimed to evaluate the benefits of elective surgery after SEMS placement vs. ES for patients (including stage IV cases) with acute MORC.

methodsPatients with acute MORC who underwent radical resection for a primary tumour from July 2008 to November 2016 at Zhongshan Hospital of Fudan University were retrospectively enrolled. Postoperative short-term outcomes, progression-free survival (PFS), and overall survival (OS) were compared between the SEMS and ES groups.

resultsIn total, 107 patients with acute MORC (35 in the SEMS group and 72 in the ES group) were included for analysis. The Intensive Care Unit admission rate was lower (11.4% vs. 34.7%, P = 0.011), the incidence of complications was reduced (11.4% vs. 29.2%, P = 0.042), and the postoperative length of hospitalisation was significantly shorter (8.23 ± 6.50 vs. 11.18 ± 6.71 days, P = 0.033) for the SEMS group. Survival curves showed no significant difference in PFS (P = 0.506) or OS (P = 0.989) between groups. Also, there was no significant difference in PFS and OS rates between patients with stage II and III colon cancer. After colectomy for synchronous liver metastases among stage IV patients, the hepatectomy rates for the SEMS and ES groups were 85.7% and 14.3%, respectively (P = 0.029). The hazard ratio for colectomy alone vs. combined resection was 3.258 (95% CI 0.858-12.370; P = 0.041).

conclusionStent placement offers significant advantages in terms of short-term outcomes and comparable prognoses for acute MORC patients. For synchronous liver metastases, SEMS placement better prepares the patient for resection of the primary tumour and liver metastasis, which contribute to improved survival.

Indexed as

Carcinoma, HepatocellularChemoembolization, TherapeuticColorectal NeoplasmsIntestinal ObstructionLiver NeoplasmsStentsAdultAgedAged, 80 and overElective Surgical ProceduresFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeLiver metastasesObstructionRight-sided colon cancerSelf-expandable metallic stent

Identifiers

PMID33302923
PMCPMC7727111
OpenAlexW3111888638

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.