Ten studies with a total of 451 patients were included in the review. There were 2 RCTs (n=52), 7 cohort studies (n=361), of which three were prospective (n=168) and four retrospective (n=193), and one case-control study (n=38).
Evidence of publication bias for all studies reporting length of hospital stay was detected; this was not found for higher quality studies but only 3 studies were plotted.
Seven studies, including the 2 RCTs, scored five or more stars on the Newcastle-Ottawa scale and were therefore considered to be of a higher quality.
Treatment details.
Stents were successfully implanted in 92.6% of patients (226 out of 244).
Hospital stay (6 studies): patients treated with stents had a shorter hospital stay (WMD -7.72, 95% CI: -11.41, -4.02, p<0.001) than those undergoing open surgery. Statistically significant heterogeneity between the studies was detected (p<0.001).
Intensive care requirement (3 studies): patients treated with stents were significantly less likely to require treatment in an intensive care unit than those undergoing open surgery (OR 0.07, 95% CI: 0.01, 0.31, p<0.001).
Short-term adverse events.
stent patients were significantly less likely to experience post-procedural medical complications (OR 0.18, 95% CI: 0.08, 0.40, p<0.001; based on 6 studies) and post-procedural mortality (OR 0.45, 95% CI: 0.22, 0.91, p<0.03; based on 7 studies). No significant heterogeneity was detected for either meta-analysis.
Long-term outcomes
Stoma requirement (8 studies): patients treated with stents were significantly less likely to undergo stoma formation at some point in their treatment (OR 0.02, 95% CI: 0.01, 0.08, p<0.001). Statistically significant heterogeneity was detected (p=0.01).
Survival (3 studies): there was no significant difference between the two groups in long-term survival (WMD 14.72, 95% CI: -77.98, 107.4, p>0.05). Statistically significant heterogeneity was detected (p=0.001).