TH3.8 Retrospective study on the use of colonic stents in malignancy; a bridge to surgery or the end of the line?

Abstract

Abstract Aim Colonic stenting is a management option for obstructed left sided colorectal malignancy in the emergency and elective setting. Stenting can provide a bridge to curative surgery or to adjuvant treatment. The aim of this study was to assess the role of colonic stenting in management of obstructed colorectal cancer. Methods This retrospective cohort study analyses prospectively collected data from two centres within one Health Board in Wales. Patients were recorded in a cancer database, who underwent colonic stenting for left sided colonic malignancy between January 2008 and December 2021. Patient demographics, treatment pathways, length of admission, stoma formation rates and morbidity were recorded. Results In total, 98 patients, with a mean age of 73.5 years (range 37–97) underwent a colonic stent. The majority were elective 55% (n=54). The sigmoid colon was the commonest site of tumour in 33 patients, with metastatic disease in 82% (n=80). The study found 86% (n=84) of patients were successfully stented. The mean length of admission was 13 days. The complication rate was 23% (n=23), most commonly stent obstruction (n=6). Stenting was a bridge to curative surgery for 3 patients, and 47% (n=46) received adjuvant treatment. Five-year survival was 19.3% (n=19). The overall stoma rate was 10.2% (10 patients). Conclusion This study shows colonic stenting is a viable alternative in surgical management for advanced obstructing colorectal malignancy but not as a bridge to surgery. The majority of this cohort returned home following stenting, had a low overall stoma rate and 19% survival at 5 years.