Role of covered and uncovered stents in obstructing colorectal tumours: a systematic review: P108


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Abstract

Aim:To systematically analyze the studies on the effectiveness of uncovered self expanding metallic stents (U-SEMS) versus covered stents (C-SEMS) in patientspresenting with large bowel obstruction (LBO) secondary to colorectal cancer (CRC).Method:All published studies comparing the effectiveness of U-SEMS versus C-SEMS in patients of LBO secondary to CRC were selected and analyzed to generate summative data.Results:Five comparative studies on 171 patients were found suitable for statistical analysis. There were 78 patients in U-SEMS group and 93 patients in C-SEMS group. U-SEMS is less likely to obstruct and migrate. Furthermore, it is also associated with fewer perioperative complications as compared to C-SEMS. C-SEMS are likely to remain patent longer than U-SEMS. Statistically, both C-SEMS and U-SEMS are equally at risk of stool impaction and poor expansion following deployment. The risk of colonic perforation remains same. Similarly, both types of colonic stents can be deployed successfully with same efficacy. There is no heterogeneity among trials.Conclusion:U-SEMS and C-SEMS are equally effective in patientspresenting with LBO secondary to CRC when used both for palliative as well as bridging purposes. U-SEMS may be deployed routinely but C-SEMS are likely to remain patent longer than U-SEMS.

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