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Stenting as a Bridge to Surgery for Obstructive Colon Cancer: Does It Have Surgical Merit or Oncologic Demerit?

Annals of Surgical Oncology, ISSN: 1534-4681, Vol: 23, Issue: 3, Page: 842-848
2016
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Article Description

Purpose: To evaluate the surgical and oncologic outcomes of patients undergoing self-expandable metallic stent (SEMS) placement with elective curative surgery. Methods: Data from patients admitted with obstructing colon cancer between 2000 and 2012 were analyzed retrospectively. Patients underwent either SEMS placement as a bridge to surgery (stent group, n = 67) or emergency surgery (surgery group, n = 35). Surgical and oncologic outcomes of the groups were compared. Results: Placement of SEMS was technically successful in 98.5 % and clinically successful in 89.6 % of cases. There were eight (11.9 %) stent-related complications, including three migrations (4.5 %), four occlusions (6.0 %), and one perforation (1.5 %). The stent group had a higher laparoscopic resection rate (67.2 vs. 31.4 %, p = 0.001) with a lower conversion rate (4.3 vs. 35.3 %, p = 0.003). The wound infection rate was significantly higher in the surgery group (37.1 vs. 11.9 %, p = 0.003) with no differences in the rate of other complications. The rates of local recurrence and distant metastasis, recurrence-free, and overall survival were not significantly different between the two groups. Conclusions: Stenting and elective surgery was associated with a higher laparoscopy rate, a lower conversion rate, and a lower wound infection rate compared to emergency surgery but did not affect recurrence or survival.

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