Self-expanding metal stents versus decompression tubes as a bridge to surgery for patients with obstruction caused by colorectal cancer - a systematic review and meta-analysis

Q: What clinical problem does the study address?

It addresses colorectal cancer–caused bowel obstruction, where emergency surgery may be required and associated with high mortality and perioperative morbidity.

Q: What treatments are compared in the systematic review?

The review compares self-expanding metal stents (SEMS) versus decompression tubes (DT) used as a bridge-to-surgery approach.

Q: Which outcomes favor SEMS over DT?

SEMS shows higher clinical success and lower rates of operation-related abdominal pain, intraoperative bleeding, stoma creation, and long-term tumor recurrence, along with shorter postoperative hospital stays.

Sep 28, 2026

Uploaded by Stanley

Systematic review and meta-analysis evaluates self-expanding metal stents (SEMS) versus decompression tubes (DT) as bridge-to-surgery strategies to avoid emergency operations in colorectal cancer obstruction. Searches across PubMed, Embase, Web of Science, SinoMed, Wanfang Data, CNKI, and Cochrane databases covered 2000-01-01 to 2023-05-30, selecting RCTs or cohort studies. Pooled evidence from 26 studies (2,061 patients) shows SEMS higher clinical success, with benefits in hospital stay, abdominal pain, intraoperative bleeding, stoma creation, and lower long-term recurrence, supporting overall safety.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages19

Reading Time48 min

AccessFree to download

Background

Methods

Results

Conclusion

Keywords

Background (epidemiology and rationale)

Trial registration

Ma etal. World Journal of Emergency Surgery (2023) 18:46 [https://doi.org/10.1186/s13017-023-00515-6](https://doi.org/10.1186/s13017-023-00515-6) World Journal of Emergency Surgery RESEARCH Open Access Self-expanding metal stents versus decompression tubes as a bridge to surgery for patients with obstruction caused by colorectal cancer: a systematic review and meta-analysis Wei Ma1†, Jian‑Cheng Zhang2,3,4†, Kun Luo1, Lu Wang2,3,4, Chi Zhang2,3,4, Bin Cai2,3,4* and Hua Jiang2,3,4* Abstract Background Using self‑expanding metal stents (SEMS) and decompression tubes (DT) as a bridge‑to‑surgery (BTS) treatment may avoid emergency operations for patients with colorectal cancer‑caused obstructions. This study aimed to evaluate the efficacy and safety of the two approaches. Methods We systematically retrieved literature from January 1, 2000, to May 30, 2023, from the PubMed, Embase, Web of Science, SinoMed, Wanfang Data, Chinese National Knowledge Infrastructure, and Cochrane Central Register of Clinical Trials databases. Randomized controlled trials (RCTs) or cohort studies of SEMS versus DT as BTS in colorec‑ tal cancer obstruction were selected. Risks of bias were assessed for RCTs and cohort studies using the Cochrane Risk of Bias tool version 2 and Risk of Bias in Nonrandomized Studies of Interventions. Certainty of evidence was deter‑ mined using the Graded Recommendation Assessment. Odds ratio (OR), mean difference (MD), and 95% confidence interval (95% CI) were used to analyze measurement data. Results We included eight RCTs and eighteen cohort studies involving 2,061 patients (SEMS, 1,044; DT, 1,017) . Pooled RCT and cohort data indicated the SEMS group had a significantly higher clinical success rate than the DT group (OR = 1 . 99, 95% CI 1. 04, 3 . 81, P = 0 . 04), but no significant difference regarding technical success (OR = 1 . 29, 95% CI 0. 56, 2 . 96, P = 0 . 55) . SEMS had a shorter postoperative length of hospital stays (MD = − 4 .47, 95% CI − 6 . 26, − 2 . 69, P < 0. 00001), a lower rates of operation‑related abdominal pain (OR = 0 . 16, 95% CI 0. 05, 0 . 50, P = 0 . 002), intraopera‑ tive bleeding (MD = − 37 . 67, 95% CI − 62 . 73, − 12. 60, P = 0 . 003), stoma creation (OR = 0 .41, 95% CI 0. 23, 0 . 73, P = 0 . 002) and long‑term tumor recurrence rate than DT (OR = 0 .47, 95% CI 0. 22, 0 . 99, P = 0 . 05) . Conclusion SEMS and DT are both safe as BTS to avoid emergency surgery for patients with colorectal cancer obstruction. SEMS is preferable because of higher clinical success rates, lower rates of operation‑related abdominal †Wei Mai and Jian‑Cheng Zhang contributed equally to this work. *Correspondence: Bin Cai[cdjianghua@qq.com](cdjianghua@qq.com)[ ](cdjianghua@qq.com)Hua Jiang [jianghua@uestc.edu.cn](jianghua@uestc.edu.cn) Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ()[. The Creative Commons Public Domain Dedication waiver (](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Pu

FAQs

What clinical problem does the study address?

It addresses colorectal cancer–caused bowel obstruction, where emergency surgery may be required and associated with high mortality and perioperative morbidity.

What treatments are compared in the systematic review?

The review compares self-expanding metal stents (SEMS) versus decompression tubes (DT) used as a bridge-to-surgery approach.

Which outcomes favor SEMS over DT?

SEMS shows higher clinical success and lower rates of operation-related abdominal pain, intraoperative bleeding, stoma creation, and long-term tumor recurrence, along with shorter postoperative hospital stays.

Sep 28, 2026

Uploaded by Stanley