[The Validity of a Stent-Independent Strategy for Left-Sided Stenotic Colon Cancer]

In recent years, stenting and stoma creation as a bridge to surgery for obstructive left-sided colon cancer have been attracting attention. Our team has a stent-independent strategy and performs primary resection after stoma construction and preoperative chemotherapy with cT4 patients. In this study, we investigated both its validity and issues. Sixty-five cases of scope-impassable left-sided colon cancer surgeries from November 2015 to September 2020 were included. The short- and long-term results were examined in Stage Ⅱ-Ⅲ and Ⅳ. The median time from admission to surgery was 6 days and 8 days, respectively; postoperative morbidity was 9.5% and 17.4%, respectively; anastomotic leakage was 4.8% and 17.4%, respectively; permanent stoma was 26.2% and 21.7%, respectively; and postoperative death was zero in both groups. In group Ⅱ-Ⅲ, the 3-year overall survival rate was 77.0%, 3-year disease-free survival rate was 72.7%, and in group Ⅳ, the 3-year overall survival rate was 36.0%. Local recurrence was observed in 2(16.7%)of 12 patients with cT3-4N+ rectosigmoid cancer who did not receive neoadjuvant chemotherapy. The stent-independent strategy was safe with low morbidity, and the permanent stoma rate was reasonable.