Abstract Aim To systematically evaluate the safety and feasibility of intraluminal bypass devices (IBDs) as alternatives to defunctioning stoma for colorectal/coloanal anastomoses after anterior resection. Method The present systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Endpoints were feasibility (placement, fixation, maintenance, removal) and safety (device‐related events, postoperative morbidity and anastomotic leakage). Results In total, 10 studies evaluating five types of IBDs were included in this systematic review. Each IBD had a head portion with a proximal fixation component and a tail portion consisting of a transanal endoluminal tubular sheath or tube for faecal diversion but with a distinct design. Device‐related events included migration, sheath internalization, partial colonic wall erosions and enterocutaneous fistula. Overall postoperative complications were reported in 0–74% and anastomotic leakage in 0–32% across studies. Stoma avoidance ranged from 66.7% to 100%. Conclusion IBDs are technically feasible and appear acceptably safe, with potential to reduce reliance on defunctioning stoma; however, evidence remains early and heterogeneous. Further studies are needed, and optimization of fixation and anti‐migration strategies should be prioritized.
Li et al. (Sun,) studied this question.
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