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Surgical Endoscopy

, Volume 27, Issue 9, pp 3121–3128 | Cite as

Oncologic safety of stent as bridge to surgery compared to emergency radical surgery for left-sided colorectal cancer obstruction

  • Hun Jin Kim
  • Jung Wook Huh
  • Wu Seong Kang
  • Chang Hyun Kim
  • Sang Woo Lim
  • Young Eun Joo
  • Hyeong Rok Kim
  • Young Jin Kim
Article

Abstract

Background

There are still concerns about the oncologic safety of stent insertion for colorectal cancer obstruction. This study investigated whether the use of stents as a bridge to surgery negatively affect the long-term outcome compared to curative surgery for left-sided colorectal cancer obstruction.

Methods

Between January 2004 and December 2009, patients with left-sided colorectal cancer obstruction without distant metastasis were retrospectively reviewed. Forty-three patients underwent radical resection after preoperative stent insertion (stent group), whereas 48 underwent emergency surgery with curative intent (surgery group). The short- and long-term outcomes between the two groups were compared.

Results

The stent and surgery groups had similar demographics. There were no significant differences in primary anastomosis, laparoscopic-assisted surgery, operation time, time until first defecation and oral intake after surgery, postoperative hospital stay, and reoperation. The stent group had an average hospital stay 7 days longer than the surgery group. During the median follow-up period of 48.1 months, the 5-year disease-free survival rates were not significantly different between the stent and surgery groups (47.2 vs. 48.9 %, respectively; p = 0.499). Overall, the 5-year survival rate was also similar in the two groups (70.4 vs. 76.4 %, respectively; p = 0.941).

Conclusions

For left-sided colorectal cancer obstruction, stent insertion followed by surgery showed short-term advantages and similar oncologic outcomes compared to surgery without preoperative intervention. Stent insertion as a bridge to surgery is a safe and feasible treatment option for patients with colorectal cancer obstruction.

Keywords

Colorectal cancer obstruction Prognosis Stent 

Notes

Disclosures

Hun Jin Kim, Jung Wook Huh, Wu Seong Kang, Chang Hyun Kim, Sang Woo Lim, Young Eun Joo, Hyeong Rok Kim, and Young Jin Kim have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Hun Jin Kim
    • 1
  • Jung Wook Huh
    • 2
  • Wu Seong Kang
    • 1
  • Chang Hyun Kim
    • 1
  • Sang Woo Lim
    • 1
  • Young Eun Joo
    • 3
  • Hyeong Rok Kim
    • 1
  • Young Jin Kim
    • 1
  1. 1.Department of SurgeryChonnam National University Hwasun Hospital and Medical SchoolGwangjuSouth Korea
  2. 2.Depatment of SurgerySamsung Medical Center, Sungkyunkwan University School of MedicineSeoulSouth Korea
  3. 3.Department of Internal MedicineChonnam National University Hwasun Hospital and Medical SchoolGwangjuSouth Korea

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