A longer interval after stenting compromises the short- and long-term outcomes after curative surgery for obstructive colorectal cancer.

Abstract

Intestinal decompression using self-expandable metallic colonic stents (SEMSs) as a bridge to surgery is now considered an attractive alternative to emergency surgery. However, data regarding the optimal timing of surgery after stenting are limited. We investigated the impact of the interval between stenting and surgery on short- and long-term outcomes in 92 obstructive colorectal cancer (OCRC) patients who had a SEMS inserted and subsequently received curative surgery. The median age of the patients was 70.5years, and the median interval between SEMS insertion and the surgery was 17 (range 5-47) days. There were 35 postoperative complications, including seven major postoperative complications. An interval of more than 16days was an independent predictor of a poor relapse-free survival (hazard ratio [HR] = 3.12, 95% confidence interval [CI] 1.24-7.81, p = 0.015). An interval of more than 35days was independently associated with major postoperative complications (HR = 16.6, 95% CI 2.21-125, p = 0.006). A longer interval between stenting and surgery significantly compromised the short- and long-term outcomes. Surgery within 16days after stenting might help maximize the benefit of SEMS without interfering with short- and long-term outcomes.