Acute abdominal obstruction: Colon stent or emergency surgery? An evidence-based review

Table 1 Commercially available colorectal stents

Manufacturer and model	Material	Delivery system	Diameter (mm)	Flare	Flare diameter (mm)	Length (mm)	Covered/uncovered
Boston Scientific
Wallstent Colonic1	Nitinol	TTS	22, 25	1	27, 30	60, 90, 120	Uncovered
Wallstent Endoprothesis1	Stainless steel	TTS	20, 22	0	–	60, 90, 120	Uncovered
Ultraflex Precision Colonic1	Nitinol	OTW	25	1	30	57, 87, 117	Uncovered
Micro-Tech Europe		OTW	30	0	–	75, 88, 112, 123, 136	Uncovered/fully covered
Micro-Tech Europe Colon and Rectum stent	Nitinol	OTW	20, 30	2	26, 36	60, 80, 100	Uncovered/partially covered
Leufen Medical GmbH		TTS	25	2	30	80, 100, 120	Uncovered
Colon Rectum Stent	Nitinol	OTW	25, 30	2	30, 36	80, 100	Uncovered/partially covered
		TTS	25	2	30	80, 100	Uncovered
Cook
Evolution Colonic1	Nitinol	TTS	25	2	30	60, 80,100	Uncovered
MI Tech
Hanarostent Colon/Rectum1	Nitinol	TTS	22, 24	2	26, 28	80, 110, 140, 170	Uncovered
		TTS/OTW	20, 24	2	26, 32	60, 90, 100, 120, 130, 160	Fully covered
		OTW	24	2	32	50,80,110,150	Fully Covered
Choostent Colon/Rectum	Nitinol	OTW	22,24	2	30, 32	100, 180	Fully covered
EndoChoice		OTW	22,24	2	30, 32	80, 120	Fully covered
Bonastent	Nitinol	TTS	22, 24, 26	0	–	60, 80, 100	Uncovered/partially covered
Taewoong Medical
Niti-S Enteral Colonic D-type1	Nitinol	TTS	18, 20, 22, 24, 26, 28	0	–	60, 80, 100, 120	Uncovered
Niti-S Enteral Colonic S-type1	Nitinol	TTS	20, 22	2	28, 30	60, 80, 100, 120	Fully/partially covered
		OTW	22, 24, 26, 28	2	30, 32, 34	60, 80, 100, 120	Fully/partially covered
Self expandable Stent
Braile Endomédica	Nitinol	TTS	26	0	-	70, 100, 130	Partially covered

¹FDA approved. TTS: Through the scope; OTW: Over the wire.

Table 2 Outcomes in studies with evidence 1A (Metanalyses of randomized studies)

Outcome	Stent as bridge to surgery;Arezzo et al[13], 2017	Stent as bridge to surgery;Arezzo et al[13], 2017	Palliative patients;Ribeiro et al[51], 2018	Palliative patients;Ribeiro et al[51], 2018
	Stent	Emergency surgery	Stent	Emergency surgery
No. of patients	251	246	63	62
Mortality	9.6%	9.9%	6.3%	6.4%
Adverse events	33.9%	51.2%	36.5%	24.1%
Survival	NA	NA	279 d	244 d
Clinical success	NA	NA	84%	96%
Technical success	NA	NA	84%	96%
Temporary colostomy	33.9%	51.4%	NA	NA
Definitive colostomy	22.2%	35.2%	14.3%	86.1%
Primary anastomosis	70%	54.1%	NA	NA
Hospital stay	15.5 d	14.5 d	17.5 d	35.5 d
ICU hospitalization	NA	NA	0	1 d

NA: Not available; ICU: Intensive care unit.