Comparison of the prognosis of four different treatment strategies for acute left malignant colonic obstruction: a systematic review and network meta-analysis

Abstract Background There is controversy regarding the efficacy of different treatment strategies for acute left malignant colonic obstruction. This study investigated 5-year overall survival (OS) and disease-free (DFS) several Methods We searched articles published in PubMed, Embase (Ovid), MEDLINE Web Science, Cochrane Library between January 1, 2000, July 2020. screened out literature comparing strategies. Evaluate primary secondary outcomes The network meta-analysis summarizes hazard ratio, odds mean difference, its 95% confidence interval. Results involved 48 articles, including 8 (randomized controlled trials) RCTs 40 non-RCTs. Primary outcomes: CS-BTS strategy DS-BTS were significantly better than those ES strategy, OS was that CS-BTS. long-term TCT-BTS not from ES. Secondary compared with emergency resection (ER) strategies, stent-bridge to surgery (CS-BTS) transanal colorectal tube-bridge (TCT-BTS) can increase anastomosis rate, decompressing stoma-bridge (DS-BTS) reduce mortality, permanent stoma rate. hospital stay longer other no significant difference anastomotic leakage levels Conclusion Comprehensive research, we find bring DFS ER. have a Without considering stays, best choice.