OBJECTIVETo study the efficacy of stenting followed by laparoscopic surgery in the treatment of obstructing left-sided colon cancer.

METHODSForty-nine patients with obstructing left-sided colon cancer were prospectively randomized into two groups. Twenty patients received emergent open surgery, while 15 underwent laparoscopic surgery 3 days after placement of the self-expanding metal stent (SEMS) and 14 of them received laparoscopic surgery 10 days after placement of SEMS. Outcomes evaluated included 1-stage operation rate, conversion rate, operative time, length of hospital stay, blood loss, postoperative pain score and use of analgesics, rates of permanent stoma, and postoperative complications.

RESULTSCompared with emergent open surgery, patients undergoing laparoscopic surgery had significantly less blood loss(P=0.000), lower permanent stoma rate (P=0.024), less pain(P=0.000), and lower incidence of postoperative complications. Laparoscopic surgery was associated with a significantly higher rate of 1-stage operation(P=0.004). Compared with patients undergoing laparoscopic surgery 3 days after SEMS placement, patients who underwent laparoscopic surgery 10 days after SEMS placement had a significantly higher 1-stage operation rate(P=0.001) and a lower conversion rate(P=0.046).

CONCLUSIONSSelf-expanding metal stenting is a safe and effective bridge to laparoscopic surgery in patients with obstructing left-sided colon cancer. Laparoscopic surgery 10 days after SEMS placement may be more appropriate.