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Short- and long-term outcomes of self-expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction
The European Society of Gastrointestinal Endoscopy does not recommend self-expanding metal stent (SEMS) placement as a bridge to surgery (BTS) for malignant colorectal obstruction (MCRO). However, no universally accepted consensus has been determined. The present study aimed to evaluate the short- a...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
D.A. Spandidos
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890458/ https://www.ncbi.nlm.nih.gov/pubmed/33680454 http://dx.doi.org/10.3892/mco.2021.2225 |
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author | Yagawa, Yusuke Kudo, Shin-Ei Miyachi, Hideyuki Mori, Yuichi Misawa, Masashi Sato, Yuta Kudo, Koki Ishigaki, Tomoyuki Ichimasa, Katsuro Kudo, Toyoki Hayashi, Takemasa Wakamura, Kunihiko Baba, Toshiyuki Ishida, Fumio |
author_facet | Yagawa, Yusuke Kudo, Shin-Ei Miyachi, Hideyuki Mori, Yuichi Misawa, Masashi Sato, Yuta Kudo, Koki Ishigaki, Tomoyuki Ichimasa, Katsuro Kudo, Toyoki Hayashi, Takemasa Wakamura, Kunihiko Baba, Toshiyuki Ishida, Fumio |
author_sort | Yagawa, Yusuke |
collection | PubMed |
description | The European Society of Gastrointestinal Endoscopy does not recommend self-expanding metal stent (SEMS) placement as a bridge to surgery (BTS) for malignant colorectal obstruction (MCRO). However, no universally accepted consensus has been determined. The present study aimed to evaluate the short- and long-term outcomes of SEMS placement vs. emergency surgery (ES) for MCRO. Surgical resection of colorectal cancer was performed in 3,840 patients between April 2001 and June 2016. Of these, 93 patients had MCRO requiring emergency decompression. Only patients in whom the colorectal lesion was ultimately resected were included; thus, the present study included 62 patients treated with MCRO via SEMS placement as a BTS (n=25) or via ES (n=37). The rates of laparoscopic surgery, primary anastomosis, stoma formation, lymph node dissection, adverse events, 30-day mortality and disease-free survival were evaluated. The clinical success rate of SEMS placement was 92.0% (23/25). Compared with the ES group, the SEMS group had higher rates of laparoscopic surgery (68.0 vs. 2.7%; P<0.001) and primary anastomosis (88.0 vs. 51.4%; P=0.003), a greater number of dissected lymph nodes (30 vs. 18; P=0.001), and lower incidences of stoma formation (24.0 vs. 67.6%; P=0.002) and overall adverse events (24.0 vs. 62.2%; P=0.004). The 30-day mortality and disease-free survival of the SEMS group were not significantly different to that of the ES group (0 vs. 2.7%; P=1.000; log-rank test; P=0.10). In conclusion, as long as adverse events such as perforation are minimized, SEMS placement as a BTS could be a first treatment option for MCRO. The present study is registered in the University Hospital Medical Network Clinical Trials Registry (UMIN R000034868). |
format | Online Article Text |
id | pubmed-7890458 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | D.A. Spandidos |
record_format | MEDLINE/PubMed |
spelling | pubmed-78904582021-03-05 Short- and long-term outcomes of self-expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction Yagawa, Yusuke Kudo, Shin-Ei Miyachi, Hideyuki Mori, Yuichi Misawa, Masashi Sato, Yuta Kudo, Koki Ishigaki, Tomoyuki Ichimasa, Katsuro Kudo, Toyoki Hayashi, Takemasa Wakamura, Kunihiko Baba, Toshiyuki Ishida, Fumio Mol Clin Oncol Articles The European Society of Gastrointestinal Endoscopy does not recommend self-expanding metal stent (SEMS) placement as a bridge to surgery (BTS) for malignant colorectal obstruction (MCRO). However, no universally accepted consensus has been determined. The present study aimed to evaluate the short- and long-term outcomes of SEMS placement vs. emergency surgery (ES) for MCRO. Surgical resection of colorectal cancer was performed in 3,840 patients between April 2001 and June 2016. Of these, 93 patients had MCRO requiring emergency decompression. Only patients in whom the colorectal lesion was ultimately resected were included; thus, the present study included 62 patients treated with MCRO via SEMS placement as a BTS (n=25) or via ES (n=37). The rates of laparoscopic surgery, primary anastomosis, stoma formation, lymph node dissection, adverse events, 30-day mortality and disease-free survival were evaluated. The clinical success rate of SEMS placement was 92.0% (23/25). Compared with the ES group, the SEMS group had higher rates of laparoscopic surgery (68.0 vs. 2.7%; P<0.001) and primary anastomosis (88.0 vs. 51.4%; P=0.003), a greater number of dissected lymph nodes (30 vs. 18; P=0.001), and lower incidences of stoma formation (24.0 vs. 67.6%; P=0.002) and overall adverse events (24.0 vs. 62.2%; P=0.004). The 30-day mortality and disease-free survival of the SEMS group were not significantly different to that of the ES group (0 vs. 2.7%; P=1.000; log-rank test; P=0.10). In conclusion, as long as adverse events such as perforation are minimized, SEMS placement as a BTS could be a first treatment option for MCRO. The present study is registered in the University Hospital Medical Network Clinical Trials Registry (UMIN R000034868). D.A. Spandidos 2021-04 2021-01-29 /pmc/articles/PMC7890458/ /pubmed/33680454 http://dx.doi.org/10.3892/mco.2021.2225 Text en Copyright: © Yagawa et al. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
spellingShingle | Articles Yagawa, Yusuke Kudo, Shin-Ei Miyachi, Hideyuki Mori, Yuichi Misawa, Masashi Sato, Yuta Kudo, Koki Ishigaki, Tomoyuki Ichimasa, Katsuro Kudo, Toyoki Hayashi, Takemasa Wakamura, Kunihiko Baba, Toshiyuki Ishida, Fumio Short- and long-term outcomes of self-expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction |
title | Short- and long-term outcomes of self-expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction |
title_full | Short- and long-term outcomes of self-expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction |
title_fullStr | Short- and long-term outcomes of self-expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction |
title_full_unstemmed | Short- and long-term outcomes of self-expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction |
title_short | Short- and long-term outcomes of self-expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction |
title_sort | short- and long-term outcomes of self-expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890458/ https://www.ncbi.nlm.nih.gov/pubmed/33680454 http://dx.doi.org/10.3892/mco.2021.2225 |
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