Abstract
AimEndoscopic decompression using the self‐expandable metallic colonic stent (SEMS) or transanal decompression tube (TDT) can convert emergency surgery into elective one‐stage surgery for obstructive colorectal cancer (OCRC). The aim of the present study was to clarify the effect of SEMS and TDT on long‐term oncological outcomes.MethodsWe retrospectively analyzed 76 consecutive pathological stage II and III OCRC patients who were inserted with SEMS or TDT as a bridge to curative surgery between 2009 and 2018.ResultsThere were 53 SEMS cases and 23 TDT cases. The tumor was located in the left colon in 58 cases and in the right colon in 18 cases. The interval between the decompression and the surgery was 16.5 days in the SEMS group and 13.0 days in the TDT group (P = 0.09). Technical and clinical success rates were 100% and 100% for SEMS, and 95% and 91% for TDT, respectively. Stoma was created in four patients in the SEMS group, and in five in the TDT group (P = 0.08). Three‐year overall survival rates of the SEMS and TDT groups were 82% and 86% (P = 0.94), and disease‐free survival rates were 68% and 62% (P = 0.79), respectively. The recurrence pattern was not significantly different.ConclusionThis study found no statistically significant differences between the effects of SEMS and TDT for OCRC as a bridge to surgery on long‐term outcomes.
Highlights
Intestinal obstruction is one of the common presenting symptoms of colorectal cancer
Self-expandable metallic colonic stent (SEMS) and transanal decompression tube (TDT) were both shown to be effective as a bridge to elective surgery, and associated with reduced morbidity and stoma rate compared to emergency surgery.[12–14]
Emergency surgery for obstructive colorectal cancer (OCRC) is associated with increased morbidity and mortality compared to elective surgery.[5]
Summary
Intestinal obstruction is one of the common presenting symptoms of colorectal cancer. Its incidence is reported as high as 30%,1,2 and obstructive colorectal cancer (OCRC) accounted for 85% of colonic emergency.[3,4]. Emergency surgery is usually indicated and this is associated with increased morbidity, mortality, and stoma rate compared to elective surgery. In some series, reported anastomotic leak rate was 2.5%~16.4%,8,9 and mortality was higher compared to left-sided OCRC,[9,10] suggesting choosing safer therapeutic options might be feasible in some cases. Self-expandable metallic colonic stent (SEMS) and transanal decompression tube (TDT) were both shown to be effective as a bridge to elective surgery, and associated with reduced morbidity and stoma rate compared to emergency surgery.[12–14]. Long-term outcomes comparing SEMS and TDT have not been reported. The aim of the present study was to clarify the effect of SEMS and TDT on long-term oncological outcomes
Sign-in/Register to view highlights & summary 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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
