Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jan-Mar;19(1):e2014.00254.
doi: 10.4293/JSLS.2014.00254.

Stenting for obstructing colon cancer: fewer complications and colostomies

Allan Mabardy  1 , Peter Miller  1 , Rachel Goldstein  1 , Joseph Coury  1 , Alan Hackford  1 , Haisar Dao  1
Affiliations

Stenting for obstructing colon cancer: fewer complications and colostomies

Allan Mabardy et al. JSLS. 2015 Jan-Mar.

Abstract

Background and objectives: Colonic stenting has been used in the setting of malignant obstruction to avoid an emergent colectomy. We sought to determine whether preoperative placement of a colonic stent decreases morbidity and the rate of colostomy formation.

Methods: Cases of obstructing sigmoid, rectosigmoid, and rectal cancer from January 1, 2010, to December 31, 2011, were identified in the Nationwide Inpatient Sample (NIS) database. All patients were treated at hospitals in the United States, and the database generated national estimates. Postoperative complications, mortality, and the rate of colostomy formation were analyzed.

Results: Of the estimated 7891 patients who presented with obstructing sigmoid, rectosigmoid, or rectal cancer necessitating intervention, 12.1% (n = 956) underwent placement of a colonic stent, and the remainder underwent surgery without stent placement. Of the patients who underwent stenting, 19.9% went on to have colon resection or stoma creation during the same admission. Patients who underwent preoperative colonic stent placement had a lower rate of total postoperative complications (10.5% vs 21.7%; P < .01). There was no significant difference in mortality (4.7% vs 4.2%; P = .69). The rate of colostomy formation was more than 2-fold higher in patients who did not undergo preoperative stenting (42.5% vs 19.5%; P < .01). Preoperative stenting was associated with increased use of laparoscopy (32.6% vs 9.7%; P < .01).

Conclusions: Our study characterizes the national incidence of preoperative placement of a colonic stent in the setting of malignant obstruction. Preoperative stent placement is associated with lower postoperative complications and a lower rate of colostomy formation. The results support the hypothesis that stenting as a bridge to surgery may benefit patients by converting an emergent surgery into an elective one.

Keywords: Colonic obstruction; Malignant bowel obstruction; Obstructing colon cancer.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Ohman U. Prognosis in patients with obstructing colorectal carcinoma. Am J Surg. 1982;143:742–747. - PubMed
    1. Deans GT, Krukowski ZH, Irwin ST. Malignant obstruction of the left colon. Br J Surg. 1994;81:1270–1276. - PubMed
    1. Tekkis PP, Kinsman R, Thompson MR, Stamatakis JD. The Association of Coloproctology of Great Britain and Ireland study of large bowel obstruction caused by colorectal cancer. Ann Surg. 2004;240:76–81. - PMC - PubMed
    1. Leitman IM, Sullivan JD, Brams D, DeCosse JJ. Multivariate analysis of morbidity and mortality from the initial surgical management of obstructing carcinoma of the colon. Surg Gynecol Obstet. 1992;174:513–518. - PubMed
    1. Sankararajah D, Forshaw MJ, Parker MC. Multicentre prospective randomised controlled trial of pre-operative endoluminal stenting vs surgery in large bowel obstruction: interim analysis of short term outcomes [Abstract]. Colorectal Dis. 2005;7(1s):73.

Publication types

MeSH terms

LinkOut - more resources