Fiori 2012.

Methods	Prospective randomised trial
Participants	22 patients January 2003 to May 2003. Stage IV unresectable colorectal cancer with symptoms of subacute obstruction > 3 months
Interventions	Colostomy 11/22; transanal self expandable metallic stent (SEMS) 11/22
Outcomes	Oral feeding and bowel function: SEMS 100% 24 hours; colostomy 100% 96 hours SEMS group further symptoms 27% (3/11): average 100 days from procedure; 2 patients had faecal impaction and 1 patient had re‐obstruction with tumour in‐growth Colostomy group no further symptoms SEMS group complications Colostomy group complications: stoma prolapse: 9% (1/11), skin irritation 9% (1/11), anaemia requiring blood transfusion 18% (2/11)
Notes	Patients and families complained the stoma significantly interfered with lifestyle; none of the patients who had stent placement complained about the procedure
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	"Patients were randomly assigned to 1 of the 2 forms of treatment according to random numbers table." Patients assigned to transanal self expanding metallic stent or diverting proximal colostomy
Allocation concealment (selection bias)	High risk	No blinding
Blinding (performance bias and detection bias) All outcomes	High risk	Patients assigned to transanal self expanding metallic stent or diverting proximal colostomy
Blinding of participants and personnel (performance bias) All outcomes	High risk	Patients assigned to transanal self expanding metallic stent or diverting proximal colostomy
Blinding of outcome assessment (detection bias) All outcomes	High risk	No blinding
Selective reporting (reporting bias)	Low risk	All patient outcomes reported Only one surgical procedure used