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首页> 外文期刊>International journal of colorectal disease. >Uncovered versus covered stent in management of large bowel obstruction due to colorectal malignancy: a systematic review and meta-analysis
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Uncovered versus covered stent in management of large bowel obstruction due to colorectal malignancy: a systematic review and meta-analysis

机译：由于结肠直肠恶性肿瘤，未覆盖的与大型肠梗阻的覆盖支架：系统评价和荟萃分析

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PurposeTo compare outcomes of uncovered stent and covered stent in management of large bowel obstruction secondary to colorectal malignancy.MethodsWe conducted a search of electronic databases identifying studies comparing outcomes of uncovered and covered stents in management of large bowel obstruction secondary to colorectal malignancy. The Cochrane risk-of-bias tool and the Newcastle-Ottawa scale were used to assess the included studies. Random or fixed effects modelling were applied as appropriate to calculate pooled outcome data.ResultsOne randomised controlled trial (RCT) and nine observational studies, enrolling 753 patients, were identified. Uncovered stent was associated with lower risks of complications (RR 0.57 95% CI 0.44-0.74, P<0.0001), tumour overgrowth (RR 0.29 95% CI 0.09-0.93, P=0.04), and stent migration (RR 0.29 95% CI 0.17-0.48, P<0.00001); longer duration of patency (MD 18.47 95% CI 10.46-26.48, P<0.00001); lower need for stent reinsertion (RR 0.38 95% CI 0.17-0.86, P=0.02); and higher risk of tumour ingrowth (RR 4.53 95% CI 1.92-10.69, P=0.0008). Rates of technical success (RR 1.02 95% CI 0.99-1.04, P=0.21), clinical success (RR 1.03 95% CI 0.98-1.08, P=0.32), perforation (RD 0.01 95% CI -0.03-0.02, P=0.65), bleeding (RD 0.00 95% CI -0.03-0.03, P=0.98), stool impaction (RR 0.56 95% CI 0.12-2.04, P=0.38) and stent obstruction (RR 2.23 95% CI 0.94-5.34, P=0.97) were similar.ConclusionsOur results suggest that uncovered stents are superior as indicated by fewer complications, lower rates of stent migration, longer duration of patency and a reduced need for stent reinsertion. The best available evidence is mainly derived from non-randomised studies; there is a need for more RCTs.
机译：Purposeto比较揭露支架的结果和覆盖在大型肠梗阻的大型肠梗阻的支架上。近期对电子数据库进行了搜索，鉴定了揭露和覆盖支架的陈述在大肠病恶性肿瘤的大肠杆菌管理中进行了研究的电子数据库。 Cochrane偏倚工具和纽卡斯尔 - 渥太华规模用于评估包括的研究。适当地应用随机或固定效果建模，以计算汇集的结果数据。鉴定了注册753名患者的综合随机对照试验（RCT）和9项观察性研究。未覆盖的支架与并发症的风险较低（RR 0.57 95％CI 0.44-0.74，P <0.0001），肿瘤过度生长（RR 0.29 95％CI 0.09-0.93，P = 0.04）和支架迁移（RR 0.29 95％CI 0.17-0.48，p <0.00001）;持续长度持续时间（MD 18.47 95％CI 10.46-26.48，P <0.00001）;降低支架再渗透的需要（RR 0.38 95％CI 0.17-0.86，P = 0.02）;肿瘤的风险较高（RR 4.53 95％CI 1.92-10.69，P = 0.0008）。技术成功率（RR 1.02 95％CI 0.99-1.04，P = 0.21），临床成功（RR 1.03 95％CI 0.98-1.08，P = 0.32），穿孔（RD 0.01 95％CI -0.03-0.02，P = 0.65），出血（RD 0.00 95％CI -0.03-0.03，P = 0.98），粪便撞击（RR 0.56 95％CI 0.12-2.04，P = 0.38）和支架梗阻（RR 2.23 95％CI 0.94-5.34，P = 0.97）是相似的.Conclusionsour结果表明，未覆盖的支架如较少的并发症，支架迁移率较低，持续时间较长，并且降低了支架再生的需求。最佳可用证据主要来自非随机研究;需要更多的RCT。

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