Benefits of using a self-expandable metallic stent as a bridge to surgery for right- and left-sided obstructive colorectal cancers
- 121 Downloads
To assess the benefit of placing a self-expandable metallic stent (SEMS) as a bridge to surgery for obstructive colorectal cancer (OCRC) according to the tumor site.
The subjects of this retrospective multicenter cohort study were 201 patients with OCRC, but without initial bowel perforation, who were treated either with a self-expandable metallic stent (SEMS) as a bridge to surgery (n = 109) or with primary surgery (PS; n = 92) between 2014 and 2016. The cohort consisted of 68 patients with right-sided and 133 left-sided OCRC. We evaluated the short-term surgical outcomes for each side.
The SEMS group of patients with left-sided OCRC had significantly higher rates of primary resection, primary resection with anastomosis, stoma-free surgery, and laparoscopic surgery than the PS group of patients with left-sided OCRC. In contrast, the SEMS group of patients with right-sided OCRC had only a significantly higher rate of laparoscopic surgery than the PS group of patients with right-sided OCRC, but they had a longer overall hospital stay. There were no significant differences between the two treatment groups in the rates of morbidity or mortality, for either right-sided or left-sided OCRC.
The benefit of a SEMS as a bridge to surgery may be less for right-sided than for left-sided obstructions in colon cancer patients.
KeywordsSelf-expandable metallic stent (SEMS) Bridge to surgery Colorectal cancer
We thank the collaborators in the institutions belonging to the CSGO: M. Miyake (National Hospital Organization, Osaka National Hospital), N. Miyoshi (Osaka International Cancer Institute), H. Tamagawa (Otemae Hospital), H. Ohta (Ikeda Municipal Hospital), Y. Nushijima (Suita Municipal Hospital), K. Danno (Osaka General Medical Center), H. Takemoto (Kinki Central Hospital of the Mutual Aid Association of Public School Teachers), Y. Fumimoto (Tondabayashi Hospital), and I. Ohashi (Hannan Chuo Hospital).
Compliance with ethical standards
Conflict of interest
Shunji Morita and his co-authors have no conflicts of interest to declare.
- 7.van Hooft JE, van Halsema EE, Vanbiervliet G, Beets-Tan RG, DeWitt JM, Donnellan F, et al. European Society of Gastrointestinal Endoscopy. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2014;46:990–1053.CrossRefGoogle Scholar
- 9.Matsuzawa T, Ishida H, Yoshida S, Isayama H, Kuwai T, Maetani I, et al. A Japanese prospective multicenter study of self-expandable metal stent placement for malignant colorectal obstruction: short-term safety and efficacy within 7 days of stent procedure in 513 cases. Gastrointest Endosc. 2015;82:697–707.CrossRefGoogle Scholar
- 17.Amelung FJ, de Beaufort HW, Siersema PD, Verhijen PM, Consten EC. Emergency resection versus bridge to surgery with stenting in patients with acute right-sided colonic obstruction: a systematic review focusing on mortality and morbidity rates. Int J Colorectal Dis. 2015;30:1147–55.CrossRefGoogle Scholar