Abstract
PurposeThe long-term oncological effects of self-expandable metallic stent (SEMS) as a “bridge to surgery” are contradictory, and perineural invasion was supposed to be enhanced by the stenting. In this retrospective study, we compared the perineural invasion and the oncological outcomes between the stent as a bridge to surgery (SBTS)- and emergency surgery (ES)-treated patients to evaluate the results of stenting on the perineural invasion.MethodsThe clinical data of patients with acute intestinal obstruction caused by colorectal cancer from January 2013 to January 2017 were retrospectively collected. Forty-three patients underwent semi-elective curative resection after endoscopic SEMS insertion, and sixty-three underwent ES. The adverse events and long-term follow-up outcomes were assessed. The clinicopathological characteristics, perineural invasion rates, and survival rates were compared between the two patient groups.ResultsStent insertion resulted in significantly lower stoma rate (32.6% vs 46%; P = 0.03), post-operative overall complication rate (11.6% vs 28.6%, P = 0.038), and total hospital stay (17.07 ± 5.544 days vs 20.48 ± 7.372 days, P = 0.042). Compared with the ES group, there was no significant increase in the incidence of peripheral invasion in the SBTS group (39.5% vs 47.6%, P = 0.411). No significant difference was noted in the survival rate and long-term prognosis between the SEMS and ES groups (P = 0.964). The technical success rate was 95.6%, and the clinical success rate was 97.7%.ConclusionsPreoperative colon stenting was an effective transitional method for colorectal cancer patients with complete obstruction. Short-term stent implantation had no significant effect on perineural invasion in patients with CRC.
Highlights
Colorectal cancer (CRC) is one of the most common malignant diseases, with more than 1.8 million new cases and 881,000 deaths in 2018
Partial or complete intestinal obstruction occurs in 7% to 29% of all patients with CRC, malignant obstruction caused by left colon
In the Self-expandable metallic stent (SEMS) group, tumours were more common in the descending colon, sigmoid colon, and rectum, whereas in the emergency surgery (ES) group, tumours were more common in the caecum and ascending colon
Summary
Colorectal cancer (CRC) is one of the most common malignant diseases, with more than 1.8 million new cases and 881,000 deaths in 2018. It is responsible for about one in ten cancer deaths. CRC is the third most common cancer and the second leading cause of mortality worldwide [1]. Partial or complete intestinal obstruction occurs in 7% to 29% of all patients with CRC, malignant obstruction caused by left colon. The long-term oncological safety of SEMS in obstruction caused by CRC remains controversial. More consideration and research are needed on long-term oncological outcomes, such as survival after insertion of SEMS [10]. In this study, we aimed to compare the perineural invasion and long-term oncological outcomes between SBTS- and EStreated patients
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call