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Comparison of Oncological and Perioperative Outcomes Between Self-Expanding Metal Stents and Decompression Tubes for Stages II and III Obstructive Colorectal Cancer: A Retrospective Observational Study

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Abstract

Background

A bridge to surgery (BTS) using self-expandable metallic stents (SEMSs) is becoming the primary treatment for obstructive colorectal cancer (OCRC). In Japan, intestinal decompression was usually performed using decompression tubes (DTs). However, few reports have compared the outcomes of SEMS and DTs as BTS. Therefore, we compared the treatment outcomes of SEMS and DTs for OCRC.

Methods

Data of 80 patients who underwent radical resection after endoscopic decompression for stage II or III OCRC between 2007 and 2021 were retrospectively analyzed. Patients were divided into two groups based on whether they received SEMS (n = 53) or DTs (n = 27).

Results

The clinical success rate of decompression was 96.2% and 88.9% in the SEMS and DT groups, respectively. Additionally, 96.2% of patients who received SEMS were able to resume their routine diet without stricture symptoms. The rate of stoma construction and incidence of postoperative complications were lower in the SEMS group (p < 0.005 and p < 0.01, respectively). The 3-year relapse-free survival rates were 71.9% and 51.2% in the SEMS and DT groups, respectively, which were not significantly different (p = 0.10).

Conclusion

BTS using SEMS might be an adequate treatment for stage II or III OCRC regardless of tumor location owing to the comparable oncological outcomes with DT and low perioperative complication rate.

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Acknowledgements

The authors would like to thank Enago (www.enago.jp) for the English language review.

Funding

No financial support was received for this report.

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Authors and Affiliations

  1. Department of Surgery, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo-shi, Shimane, 693-8555, Japan

    Kei Yamane, Yosuke Umino, Tadashi Nagami, Koji Tarumoto, Kuniaki Hattori, Ryo Maemoto, Junji Iwasaki & Akiyoshi Kanazawa

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  1. Kei Yamane
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  2. Yosuke Umino
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  3. Tadashi Nagami
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Correspondence to Kei Yamane.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

Human and animal rights

The protocol for this research project has been approved by the Shimane Prefectural Central Hospital Institutional Review Board (approval code: R22-029), and it conforms to the provisions of the Declaration of Helsinki. All informed consent was obtained from the subjects and/or guardians.

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Yamane, K., Umino, Y., Nagami, T. et al. Comparison of Oncological and Perioperative Outcomes Between Self-Expanding Metal Stents and Decompression Tubes for Stages II and III Obstructive Colorectal Cancer: A Retrospective Observational Study. World J Surg 47, 2279–2286 (2023). https://doi.org/10.1007/s00268-023-07044-y

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