SP10.2 Systematic review and meta-analysis of self-expanding metal stents in the management of benign large bowel obstruction
Armin Fardanesh, Jayan George, Daniel Hughes, Stavroula Stavropoulou-Tatla, Pawan Mathur- Surgery
Abstract
Aims
Methods
This systematic review protocol was registered on Prospero (ID: CRD42021239363). Seven online databases were searched for relevant papers, with subsequent abstract and full-text screening by two reviewers. The primary outcome was the technical success of stenting. Pooled rates of successful stenting and related complications were calculated through meta-analysis of proportions performed using random effects.
Results
266 papers were collected with 15 studies included for analysis. 290 patients were included with an average age of 68, and a male predominance of 57%. The pooled rate of clinical success was 94.4% (95%CI 90.3 – 96.8%). The pooled rate of technical success was 76.0% (95%CI: 64.9-84.5%). Adverse effects were low; perforation 9% (19.9 – 38.6%), recurrence 28% (19.9 – 38.6%) and stent migration (14.6 – 36.0%). The reporting on long-term outcomes of stenting as a bridge to surgery was vastly variable.
Conclusions
This study demonstrates SEMS could be clinically effective and safe in benign LBO. We propose the introduction of a widescale database to assess current practice and its clinical application.