Comparison of Self-Expanding Metallic Stenting with Emergency Surgery as First-Management for Obstructing Primary Left-sided Colorectal Cancer.
- Author:
Ji Won PARK
1
;
Min Ro LEE
;
Chang Won HONG
;
Sang Nam YOON
;
Hyoung Chul PARK
;
Se Hyung KIM
;
Joon Koo HAN
;
Kyu Joo PARK
;
Jae Gahb PARK
Author Information
1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. jgpark@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Colonic obstruction;
Colorectal cancer;
Self-expanding metallic stents
- MeSH:
Colorectal Neoplasms*;
Disease-Free Survival;
Emergencies*;
Humans;
Length of Stay;
Mortality;
Retrospective Studies;
Seoul;
Stents*
- From:Journal of the Korean Society of Coloproctology
2006;22(1):41-46
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Emergency surgery has been a conventional treatment for malignant large-bowel obstruction, but is associated with high morbidity and mortality. Recently, self-expanding metallic stents (SEMS) have provided a new modality as palliation or bridge therapy for patients with obstructing colorectal cancers. The purpose of the present study is to evaluate whether SEMS is useful in patients with malignant large bowel obstruction. METHODS: Between January 1999 and June 2004, 63 patients were treated for primary obstructing left-side colorectal cancer at the Department of Surgery, Seoul National University Hospital. 32 patients were managed firstly with SEMS (stent group), and 31 patients underwent an emergency operation (emergency surgery group). Clinical data were retrospectively reviewed. The results, including perioperative outcome and survival, were compared between the two groups. RESULTS: Clinicopathological parameters, including age, gender, ASA grade, tumor location and stage, were similar between the two groups. The rate of one-stage operations was significantly higher in the stent group (52% vs 13%; P=0.004). The stent group was associated with a lower rate of stoma formation (48% vs 87%; P=0.004), a shorter length of hospital stay (19 days vs 26 days; P=0.048), and fewer complications (7% vs 30%; P= 0.035). The overall and the disease-free survival rates were similar between the two groups (P=0.973, 0.126). The stent group was associated with fewer surgeries needed, shorter length of hospital stay, and fewer complications. CONCLUSIONS: Stenting with SEMS is useful in managing malignant large-bowel cancer with obstruction and may be better than traditional open surgery.
