Self-expanding metallic stent as a bridge to surgery versus emergency surgery for acute obstructive colorectal cancer: a retrospective study
Authors Wang Y, Hu H, Wang M, Han X, Zhang Q, Yu L, Chen Y, Wang G
Received 30 October 2018
Accepted for publication 8 February 2019
Published 5 April 2019 Volume 2019:11 Pages 2709—2718
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Xueqiong Zhu
Yuliuming Wang, Hanqing Hu, Meng Wang, Xiao Han, Qian Zhang, Lei Yu, Yinggang Chen, Guiyu Wang
Department of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
Purpose: Acute obstructive colorectal cancer is a common emergency that requires decompression immediately. The aim of the study was to compare short-term and long-term results of acute obstructive colorectal cancer treated by the self-expanding metallic stent (SEMS) as a bridge to surgery (BTS) versus emergency surgery.
Patients and methods: We retrospectively reviewed 78 patients who were diagnosed as acute obstructive colorectal cancer that underwent elective surgery after stent insertion (stent group, N=37) or emergency surgery (emergency group, N=41) from January 2013 to October 2016. The Kaplan–Meier method was conducted to calculate overall survival. Univariate analyses were performed using the Mann–Whitney U analysis, Pearson’s chi-square test, and Fisher’s exact test. In addition, continuous variables were compared using the Student’s t-test.
Results: The baseline characteristics were not significantly different between the two groups. The stent group had increased preoperative serum albumin level and decreased ASA risk score. In addition, operation time, diet time, harvested lymph nodes and total stoma creation of the stent group were better than that of the emergency group. The complications and mortality during hospitalization were not significantly different between the two groups. The overall survival was not significantly different while the quality of life of survival patients in the stent group was better than that of the emergency group.
Conclusion: For acute obstructive colorectal cancer, a stent as a BTS seems to be a safe and feasible alternative option for emergency surgery in the management of acute obstructive colorectal cancer.
Keywords: obstructive colorectal cancer, self-expanding metallic stent, bridge to surgery
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