Clinical outcomes of metallic stent insertion for obstructive colorectal cancer

As the treatment of acute malignant obstruction of the left colon, self-expandable metallic stent insertion has been clinically used with good results. The aim of this study is to analyze the outcome of planned operation after stent insertion for obstructive colorectal cancer.

From 2000 to 2003, among 37 patients treated for obstructive colorectal cancer, we compared hospital days and complications between Group A (n=18) and Group B (n=19). Group A included the patients who underwent planned operation after stent insertion and Group B included the patients who underwent planned operation after emergency temporary colostomy formation.

In Group A, complications after stent insertion were perforation with abscess formation (n=1) and stent migration (n=2). Complications after definitive operation were not observed. In Group B, complications after temporary colostomy involed stoma site wound infection (n=2). Complications after definitive surgery were as follows: anastomotic leakage (n=1), pneumonia with acute renal failure (n= 1), wound infection (n=2). In group A and group B, hospital day after decompressive procedure was 5+/-4.0 days (range, 1-16 days) vs. 14+/-4.7 days (range, 7-27 days) (P=0.000). Hospital day after definitive operation was 11+/-4.0 days (range 8-22 days) vs. 16+/-9.2 days (range 10-41 days) (P=0.002).

Because preoperative self-expandable metallic stent insertion for obstructive colorectal cancer had better postoperative results and shorter hospital days than emergent diverting colostomy, this procedure is a good "bridge to surgery".