Meta-analysis Of The Efficacy And Prognosis Of Elective Surgery And Emergency Surgery After Colonic Stenting For Obstructive Colon Cancer

Objective:To systematically evaluate the efficacy and prognosis of elective surgery and emergency surgery after colonic stenting in the treatment of colon cancer complicated with obstruction.Methods:Randomized controlled trials on elective surgery and emergency surgery for obstructive colon cancer after colonic stent implantation were searched from CNKI,Wanfang,VIP,China Biomedical Literature Database(CBM),Pubmed,Cochrane Library,EMBase and other databases by computer,and literatures were screened and their quality was evaluated.Relevant data were extracted and Meta analysis was performed using Revman5.3 software.Results:A total of 820 patients(408 in the stent group and 412 in the surgery group)were included in this study.The analysis results showed that: Compared with emergency surgery,elective surgery after colon stent implantation had a higher first-stage surgical anastomosis rate(P=0.004),a lower permanent stomy rate(P=0.0002),a lower complication rate(P=0.0007),and a lower wound infection rate(P=0.0008),and the differences were statistically significant.The perioperative mortality(P=0.83),incidence of anastomotic fistula(P=0.20),pulmonary infection rate(P=0.14),recurrence rate(P=0.08),3-year overall survival rate(P=0.69)and 3-year disease-free survival(P=0.72)were compared between the stent group and the operation group,and the difference was not statistically significant.Conclusions:Compared with emergency surgery,colonic stenting as a surgical transition for the treatment of malignant obstruction of the colon can improve the rate of primary surgical anastomosis,reduce the rate of permanent ostomy and the incidence of total complications,with better short-term clinical efficacy.