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Self-expanding Metallic Stent as a Bridge to Surgery Versus Emergency Surgery for Acute Obstructive Colorectal Cancer: A Retrospective Study

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Self-expanding Metallic Stent as a Bridge to Surgery Versus Emergency Surgery for Acute Obstructive Colorectal Cancer: A Retrospective Study

Yuliuming Wang et al. Cancer Manag Res.

Abstract

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: bridge to surgery; obstructive colorectal cancer; self-expanding metallic stent.

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Patient selection flowchart. A total of 78 patients diagnosed with acute obstructive colorectal cancer who underwent elective surgery after stent insertion or emergency surgery from January 2013 to October 2016 were included in this study. Abbreviation: SEMS, self-expanding metallic stent.
Figure 2
Figure 2
Analysis of preoperative serum albumin level of patients in SG and EG. The median of serum albumin level was 36.6 and 34.1 for the stent group and emergency group, respectively. * Statistically significant (P<0.05). Abbreviations: SG, stent group; EG, emergency group.
Figure 3
Figure 3
Overall survival of patients in SG and EG. The median overall survival was 36 months for both groups. Abbreviations: SG, stent group; EG, emergency group.

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