Short- and long-term outcomes after colonic self-expandable metal stent placement for malignant large-bowel obstruction
- PDF / 984,051 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 41 Downloads / 200 Views
(2020) 18:265
RESEARCH
Open Access
Short- and long-term outcomes after colonic self-expandable metal stent placement for malignant large-bowel obstruction as a bridge to surgery focus on the feasibility of the laparoscopic approach: a retrospective, single center study Jesse Yu Tajima1, Nobuhisa Matsuhashi1*, Takao Takahashi1, Chika Mizutani1, Yoshinori Iwata1, Shigeru Kiyama3, Masaya Kubota2, Takashi Ibuka2, Hiroshi Araki2, Masahito Shimizu2, Kiyoshi Doi3 and Kazuhiro Yoshida1
Abstract Purpose: Malignant large-bowel obstruction (MLBO) is a highly urgent condition in colorectal cancer with high complication rates. Self-expandable metal stent (SEMS) placement in MLBO is a new decompression treatment in Japan. Preoperative stent placement (bridge to surgery: BTS) avoids emergency surgery, but oncological influences of stent placement and post-BTS surgical approach remain unclear. We examined short- and long-term results of surgery for MLBO after SEMS placement in our hospital. Methods: We retrospectively reviewed 75 patients with MLBO who underwent resection after SEMS placement at our hospital from June 2013 to December 2018. Postoperative morbidity and mortality were evaluated by comparison with the surgical approach. Results: Tumor location was significantly higher in the left-side colon and rectum (n = 59, 78.7%) than right-side colon (n = 16, 21.3%). Technical and clinical success rates for SEMS placement were 97.3% and 96.0%, respectively. Laparoscopic surgery was performed in 54 patients (69.0%), and one-stage anastomosis was performed in 73 (97.3%). Postoperative complications were similar in the open surgery (open) group (n = 5, 23.8%) and laparoscopic surgery (lap) group (n = 7, 13.0%), with no severe complications requiring reoperation. Three-year overall survival (OS) and relapse-free survival (RFS) rates were not significantly different in the lap vs open group (67.5% vs 66.4%; 82.2% vs 62.5%). Conclusion: Preoperative stent treatment avoids stoma construction but allows anastomosis. One-time surgery was performed safely contributing to minimally invasive treatment and acceptable short- and long-term results. Keywords: Malignant large-bowel obstruction, Self-expandable metal stent placement, Bridge to surgery, Postoperative complication * Correspondence: [email protected] 1 Department of Surgical Oncology, Gifu University Hospital, 1-1 Yanagido, Gifu-city, Gifu 501-1194, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If
Data Loading...
