eP514 - Comparing Intestinal Tube Catheterization and Metal Stenting for Obstructive Colorectal Cancer: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Purpose/Background: Obstructive colorectal cancer (OCC) demands urgent intervention to mitigate bowel obstruction. Utilized interventions include intestinal tube catheterization and colonoscopic metal stenting (CMS), each with distinct efficacy and safety profiles. A comparative analysis of these interventions is critical for refined clinical decision-making and potentially enhancing patient care outcomes. This study aims to compare the efficacy and safety of colonoscopic metal stenting (CMS) and intestinal tube catheterization (ITC) in managing obstructive colorectal cancer.Methods/Interventions: A systematic search of PubMed, EMBASE, and the Cochrane Library databases was conducted until July 2023 to identify randomized clinical trials comparing ITC and CMS for OCC. Evaluated outcomes included technical success, clinical success, perforation, anastomosis leakage, and overall infection rate. Statistical analyses were done using R software (version 4.0.3) with metafor and meta packages, employing random effects models to derive pooled Relative Risks (RRs) for categorical outcomes.Results/Outcomes: The meta-analysis incorporated 5 randomized clinical trials, enrolling a total of 423 patients (212 in the ITC group and 211 in the CMS group). Both technical and clinical success rates were modestly higher in the ITC group (Technical success: RR=1.10, 95% CI [1.002, 1.21], P=0.04, I2=73%; Clinical success: RR=1.11, 95% CI [1.02, 1.21], P=0.02, I2=19%). Anastomosis leakage risk was comparable between the two groups (RR=0.65, 95% CI [0.12, 3.61], P=0.62). One study reported a single instance of perforation in the CMS group, with no significant difference in overall infection rate between the groups (RR=0.89, 95% CI [0.38, 2.07], P=0.79, I2=0%).Conclusion/

Discussion: The findings indicate a modest advantage in technical and clinical success rates for intestinal tube catheterization compared to colonoscopic metal stenting in managing obstructive colorectal cancer. The adverse event profiles concerning anastomosis leakage, perforation, and overall infection rate were similar between both interventions. The modest difference in technical and clinical success necessitates cautious interpretation. Further research with long-term follow-up and larger sample sizes is essential to substantiate these findings and to fully understand the long-term impact on patient survival and quality of life.