Abstract:

Objective

To compare the efficacy and prognosis of neoadjuvant chemotherapy and elective surgery in the treatment of colorectal cancer induced intestinal obstruction after stent implantation.

Methods

The studies published from the establishment of the database to September 30， 2024，were searched from CNKI， Wanfang database， and VIP database.R studio software was used for data analysis.

Results

A total of 10 studies were included in this meta-analysis.Compared to direct surgery after intestinal stent implantation， elective surgery after intestinal stent implantation combined with neoadjuvant chemotherapy had significant higher laparoscopic surgeryrate（OR=2.96， 95%CI： 1.72～5.10）， diseasefree survival rates（OR=2.15， 95%CI： 1.24～3.72）， and overall survival （OR=1.92， 95%CI： 1.06～3.49） （P＜0.05）， and had significant lower ostomy rate（OR=0.28， 95%CI： 0.16～0.48）， post-operative complications rate（OR=0.41， 95%CI： 0.26～0.66）， local recurrence rate（OR=0.40， 95%CI： 0.20～0.82）， intraoperative blood loss（SMD=-1.24， 95%CI： -2.09～-0.40）， first postoperative exhaust time （SMD=-0.60， 95%CI： -1.00～-0.21） and length of stay after surgery （SMD=-1.12， 95%CI： -1.57～-0.67） （P＜0.05）.

Conclusion

Stent implantation combined with neoadjuvant chemotherapy is safer and more efficient than direct surgery after stent implantation combined with conventional treatment.

Key words: Colorectal neoplasms, Acute large bowel obstruction, Neoadjuvant chemotherapy, Colonic stent, Meta analysis