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Stenting for colorectal cancer obstruction compared to surgery—a study of consecutive patients in a single institution

  • Eva AngeneteEmail author
  • Dan Asplund
  • Maria Bergström
  • Per-Ola Park
Original Article

Abstract

Background

Colonic obstruction is a common complication to colorectal cancer and surgical treatment is associated with high morbidity and mortality. Stenting has emerged as an alternative to surgery. The aim of this study was to compare short-term morbidity, mortality and hospital stay between treatment with self-expandable metallic stent and emergency surgery performed at our department during a 5-year period in a non-randomized setting.

Methods

Patients with colonic obstruction due to rectal or colon cancer referred to the Endoscopic Unit or Surgical Department for insertion of a colonic stent between 1 August 2003 and 1 August 2008 were prospectively registered and followed (n = 112). A control group was identified using the hospital records of operations with the International Classification Code-10 (ICD-10) for bowel obstruction and colorectal cancer (n = 60). Age, gender, indication, preoperative investigations, surgical procedure, complications and procedure-related mortality were registered. Patients were followed in accordance with local guidelines.

Results

The complication rate was similar in the two groups, although there was a trend toward a higher number of severe complications in the surgical group. The hospital stay was significantly lower in the stent group, median of 4 vs. 9 days (p < 0.0001). The procedure-related mortality was lower in the stent group; 7% vs. 20% (p < 0.05).

Conclusions

Stenting can be safely performed with lower or similar complication rate and lower mortality rate compared to surgery and results in significantly shorter hospital stay. The results support stenting as the treatment of choice in patients with acute colonic obstruction, especially in disseminated disease.

Keywords

SEMS Colon Rectum Cancer Endoscopy Stent 

Notes

Disclosures

All authors have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Eva Angenete
    • 1
    • 2
    • 4
    Email author
  • Dan Asplund
    • 1
    • 2
    • 4
  • Maria Bergström
    • 3
    • 4
  • Per-Ola Park
    • 3
    • 4
  1. 1.Department of SurgerySahlgrenska University Hospital/Östra SjukhusetGothenburgSweden
  2. 2.SSORG - Scandinavian Surgical Outcomes Research GroupGothenburgSweden
  3. 3.Department of SurgerySödra Älvsbors SjukhusBoråsSweden
  4. 4.The Sahlgrenska Academy, University of GothenburgGothenburgSweden

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