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World J Gastroenterol. Sep 7, 2013; 19(33): 5565-5574
Published online Sep 7, 2013. doi: 10.3748/wjg.v19.i33.5565
Published online Sep 7, 2013. doi: 10.3748/wjg.v19.i33.5565
Palliative treatment for incurable malignant colorectal obstructions: A meta-analysis
Xiao-Dan Zhao, Ri-Sheng Cao, Rui-Hua Shi, Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Bao-Bao Cai, Department of General Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Zhao XD and Cai BB are considered co-first authors as they contributed equally to performing the research, analyzing the data, and contributing new reagents or analytical tools; Zhao XD wrote the paper; Cao RS contributed new reagents or analytical tools; Shi RH designed the research study.
Supported by A grant from the Innovative Team Project, No. CX11, to Shi RH
Correspondence to: Rui-Hua Shi, MD, PhD, Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. ruihuashi@126.com
Telephone: +86-25-83674636 Fax: +86-25-83674636
Received: February 26, 2013
Revised: May 30, 2013
Accepted: July 4, 2013
Published online: September 7, 2013
Revised: May 30, 2013
Accepted: July 4, 2013
Published online: September 7, 2013
Core Tip
Core tip: This meta-analysis demonstrates the advantages of self-expandable metal stent (SEMS) placement as palliative therapy for incurable malignant colorectal obstructions. Specifically, when compared to the outcomes of surgical treatment, the SEMS treatment is associated with shorter hospital stay and interval to chemotherapy initiation, as well as lower early morbidity and 30-d mortality rates. These advantageous features may surmount the overall lower rate of palliative efficacy when considering treatment options for cases with extensive metastatic disease or severe comorbid medical illness that disqualify a patient from operative candidacy; regardless, SEMS application should be performed as an alternative to surgery with caution.