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World Journal of Surgery

, 33:1281 | Cite as

Oncologic Outcomes of Self-Expanding Metallic Stent Insertion as a Bridge to Surgery in the Management of Left-Sided Colon Cancer Obstruction: Comparison with Nonobstructing Elective Surgery

  • Jin Soo Kim
  • Hyuk Hur
  • Byung Soh Min
  • Seung Kook Sohn
  • Chang Hwan Cho
  • Nam Kyu Kim
Article

Abstract

Background

Self-expanding metallic stents (SEMS) have been used as a bridge to surgery in patients with obstruction by colorectal cancer, but the oncologic safety of this technique has not yet been established. The aim of the present study was to compare the outcomes of bridge to surgery after SEMS insertion and nonobstructing elective surgery.

Methods

Between October 1999 and July 2007, 35 patients who had left-sided colon malignancy obstruction and underwent surgical resection after SEMS insertion (group A) were matched to 350 patients who underwent elective surgery for nonobstructing left-sided colon cancer based on stage II, III, and IV malignancies according to the 2001 American Joint Committee on Cancer (group B). Group B was randomly extracted from the colorectal database of our institute. The two groups were compared for clinicopathologic variables, complications, and survival rate.

Results

There were no significant differences in clinicopathologic variables between group A and group B. However, the stoma formation rate was statistically different between the two groups (p = 0.003). Self-expanding metallic stent insertion had an adverse effect on the 5-year overall survival rate (A vs. B, 38.4% vs. 65.6%, respectively; p = 0.025) and the 5-year disease-free survival rate (A vs. B, 48.3% vs. 75.5%, respectively; p = 0.024).

Conclusions

These data show that insertion of SEMS as a bridge to surgery in the management of left-sided colon cancer obstruction is possibly associated with adverse oncologic outcomes compared with nonobstructing elective surgery, but it is unclear what magnitude of this effect is related to the underlying obstruction rather than to the SEMS.

Keywords

Oncologic Outcome Stent Insertion Stent Group Colonic Obstruction SEMS Placement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

This work was supported by a grant from the Korea Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea (0412-CR01-0704-0001, 0405-BC01-0604-0002).

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Copyright information

© Société Internationale de Chirurgie 2009

Authors and Affiliations

  • Jin Soo Kim
    • 1
  • Hyuk Hur
    • 1
  • Byung Soh Min
    • 1
  • Seung Kook Sohn
    • 1
  • Chang Hwan Cho
    • 1
  • Nam Kyu Kim
    • 1
  1. 1.Department of SurgeryYonsei University College of MedicineSeoulKorea

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