Colonic stenting as a bridge to surgery for obstructive colorectal cancer: advantages and disadvantages

Naotsugu Haraguchi, Masataka Ikeda, Masakazu Miyake, Takuya Yamada, Yuko Sakakibara, Eiji Mita, Yuichiro Doki, Masaki Mori, Mitsugu Sekimoto

研究成果: Contribution to journalArticle査読

15 被引用数 (Scopus)

抄録

Purpose: To clarify the advantages and disadvantages of stenting as a bridge to surgery (BTS) by comparing the clinical features and outcomes of patients who underwent BTS with those of patients who underwent emergency surgery (ES). Methods: We assessed technical success, clinical success, surgical procedures, stoma formation, complications, clinicopathological features, and Onodera’s prognostic nutritional index (OPNI) in patients who underwent BTS and those who underwent ES. Results: Twenty-six patients underwent stenting, which was successful in 22 (BTS group). The remaining four patients with unsuccessful stenting underwent emergency surgery. A total of 22 patients underwent emergency surgery (ES group). The rates of technical and clinical success were 85.0 and 81.0 %, respectively. The proportion of patients able to be treated by laparoscopic surgery (P = 0.0001) and avoid colostomy (P = 0.0042) was significantly higher in the BTS group. Although the incidence of anastomotic leakage in the two groups was not significantly different, it was significantly reduced by colonoscopic evaluation of obstructive colitis (P = 0.0251). The mean number of harvested lymph nodes (P = 0.0056) and the proportion of D3 lymphadenectomy (P = 0.0241) were significantly greater in the BTS group. Perineural invasion (PNI) was noted in 59.1 and 18.2 % of the BTS group and ES group patients, respectively (P = 0.0053). OPNI and serum albumin decreased significantly after stenting (P = 0.0084). Conclusions: The advantages of stenting as a BTS were that it avoided colostomy and allowed for laparoscopic surgery and lymphadenectomy, whereas its disadvantage lay in the decreased PNI and OPNI levels. A larger study including an analysis of prognosis is warranted.

本文言語英語
ページ(範囲)1310-1317
ページ数8
ジャーナルSurgery today
46
11
DOI
出版ステータス出版済み - 11 1 2016
外部発表はい

All Science Journal Classification (ASJC) codes

  • Surgery

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