Short- and long-term outcomes of a self-expandable metallic stent versus a transanal decompression tube for pathological stage II and III left-sided obstructive colorectal cancer: a retrospective observational study

• Published in: Surgery today (Tokyo, Japan) Vol. 52; no. 2; pp. 268 - 277
• Main Authors: Sato, Kentaro, Imaizumi, Ken, Kasajima, Hiroyuki, Kurushima, Michihiro, Umehara, Minoru, Tsuruga, Yosuke, Yamana, Daisuke, Obuchi, Keisuke, Sato, Aya, Nakanishi, Kazuaki
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.02.2022
• Subjects: Aged; Aged, 80 and over; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Decompression, Surgical - instrumentation; Decompression, Surgical - methods; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Original Article; Retrospective Studies; Self Expandable Metallic Stents; Surgery; Surgical Oncology; Time Factors; Treatment Outcome; Obstructive colorectal cancer; Oncological outcomes; Self-expandable metallic stent; Transanal decompression tube; Bridge to surgery
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-021-02341-2

Purpose Few studies have investigated the long-term oncological outcomes of the self-expandable metallic stent (SEMS) as a bridge to surgery (BTS) for obstructive colorectal cancer (OCRC). We conducted this study to compare the short- and long-term outcomes of the SEMS with those of the traditional transanal decompression tube (TDT) in patients with stage II and III left-sided OCRC. Methods The subjects of this retrospective study were 78 patients with pathological stage II and III left-sided OCRC who underwent radical surgery after SEMS or TDT placement, between April, 2005 and September, 2019. We compared perioperative data, including decompression success rates and 3-year relapse-free survival (RFS), between the SEMS and TDT groups. Results A SEMS was placed in 60 (76.9%) patients and a TDT was placed in 18 (23.1%) patients, achieving a clinical success rate of decompression of 98.3% in the SEMS group and 77.8% in the TDT group ( P  = 0.009). The 3-year RFS of the overall cohort was better in the SEMS group than in the TDT group (74.9% vs. 40.9%, respectively; P  = 0.003). Conclusions Decompression using a SEMS as the BTS may improve oncological outcomes over those achieved by a TDT in patients with left-sided stage II and III OCRC.