Evidence map›Paper›PMID 39028327›Full record

SynthesisTechniques in coloproctology2024

The use of self-expanding metallic stents in the management of benign colonic obstruction: a systematic review and meta-analysis.

Armin Fardanesh, Jayan George, Daniel Hughes, Stavroula Stavropoulou-Tatla, Pawan Mathur

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Techniques in coloproctology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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.

Armin FardaneshDepartment of General Surgery, Royal London Hospital, Bart's Health NHS Foundation Trust, London, England, UK.ORCID 0000-0003-1076-4592
Jayan GeorgeDepartment of General Surgery, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Sheffield, England, UK. jayan.george@aol.com.ORCID 0000-0001-8899-6620
Daniel HughesDepartment of UGI Surgery, Royal Berkshire NHS Foundation Trust, Reading, England, UK.ORCID 0000-0002-7167-1325
Stavroula Stavropoulou-TatlaDepartment of Plastic Surgery, St George's University Hospitals NHS Foundation Trust, London, England, UK.
Pawan MathurDepartment of General Surgery, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, England, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPatients presenting with large bowel obstruction (LBO) frequently undergo emergency surgery that is associated with significant morbidity. In malignant LBO, endoscopic approaches with placement is a self-expanding metal stent (SEMS), have been proposed to prevent emergency surgery and act as a bridge to an elective procedure-with the intention of avoiding a stoma and reducing morbidity. This systematic review aims to assess the quality and outcomes of data available on the use of SEMS in benign causes of colonic obstruction.

methodsThis systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the protocol was registered on Prospero (ID: CRD42021239363). PUBMED, MEDLINE, HMIC, CINAHL, AMED, EMBASE, APA and Cochrane databases were searched. Studies were assessed for quality utilising the MINORS criteria. Pooled odds ratios with 95% confidence intervals (95% CI) were calculated using random effects models.

resultsSixteen studies were included for analysis. 300 patients were included with an average age of 68, and a male predominance of 57%. The quality of the papers included were at risk of bias. The pooled rate of technical success of procedure was 94.4% (95% CI 90.5-96.8%) The pooled rate of clinical success was 77.6% (95% CI: 66.6-85.7%). Adverse effects were low, with perforation 8.8% (4.5-16.6%), recurrence 26.5% (17.2-38.5%) and stent migration 22.5% (14.1-33.8%). DISCUSSION: This systematic review demonstrated that SEMS for benign colonic obstruction can be a safe and successful procedure. The utilisation of SEMS in malignant disease as a bridge to surgery has been well documented. Whilst the limitations of the data interpreted are appreciated, we postulate that SEMS could be utilised to decompress patients acutely and allow pre-operative optimisation, leading to a more elective surgery with less subsequent morbidity.

Indexed as

Colonic DiseasesIntestinal ObstructionSelf Expandable Metallic StentsAgedFemaleHumansMaleMiddle AgedTreatment OutcomeBenignBenign colonic obstructionLarge bowel obstructionMeta-analysisSelf-expanding metal stentsStenting

Identifiers

PMID39028327
PMCPMC11271435

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Registered trials

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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.