To compare the short-and long-term efficacy after endoscopic stent versus stoma decompression as a bridge to elective resection for obstructive colorectal cancer.

The databases such as PubMed, Embase, Cochrane Library, CNKI, WanFang data were searched to retrieve literature comparing stoma decompression with endoscopic stent as a bridge to surgery for obstructive colorectal cancer. Data were extracted and analyzed using RevMan 5.3 statistical software.

Ten retrospective case-control studies were finally retrieved, with 6-8 points by the Newcastle-Ottawa Scale, 6 of which were high-quality literatures. A total of 1 807 cases were included in the study, 939 of whom were divided into stoma group and 868 were stent group. Compared to the stoma group, the stent group was associated with significantly shorter time interval between decompression surgery and elective resection for obstructive colorectal cancer (WMD=13.37, 95% CI: 7.88-18.86, P<0.000 01). However, the stoma group showed better primary anastomotsis (OR=1.58, 95% CI: 1.10-2.26, P=0.01) and 3-year overall survival than the stent group (HR=0.77, 95% CI: 0.61-0.97, P=0.02). No significant differences were found in terms of surgical approach, permanent stoma, overall complication and perioperative mortality between the two groups.

The stoma decompression as a bridge to surgery provides similar safety with endoscopic stent for patients with obstructive colorectal cancer undergoing subsequent elective radical resection. However, stoma decompression has advantages of long-term efficacy, providing higher overall survival.