A Bridge to Curative Surgery for Obstructive Colorectal Cancer: Self-expandable Metallic Stent Versus Decompression...

Area of Science:

• Gastroenterology
• Surgical Oncology
• Medical Devices

Background:

• Self-expandable metallic stents (SEMS) are increasingly used as a bridge-to-surgery (BTS) strategy for obstructive colorectal cancer (OCRC).
• Current evidence primarily focuses on left-sided OCRC, with less data available for right-sided cases.

Purpose of the Study:

• To evaluate the effectiveness of SEMS placement as a BTS strategy for both right- and left-sided OCRC.
• To compare short- and long-term outcomes of SEMS versus decompression tube (DCT) placement in OCRC patients.

Main Methods:

• Retrospective comparison of 57 patients with stage II/III OCRC (right-sided: DCT n=20, SEMS n=8; left-sided: DCT n=9, SEMS n=20).
• Short-term outcomes included postoperative complications, laparoscopic surgery rate, stoma construction rate, and hospital stay.
• Long-term outcomes assessed were 3-year overall survival (OS) and relapse-free survival (RFS).

Main Results:

• SEMS group showed higher laparoscopic surgery rates (85.7% vs. 6.9%) and lower stoma rates (10.7% vs. 34.5%) than DCT group.
• Postoperative hospital stay was shorter in the SEMS group (14 vs. 17 days).
• No significant differences in postoperative complications, 3-year OS, or RFS were observed between SEMS and DCT groups for both right- and left-sided OCRC.

Conclusions:

• SEMS placement is a viable bridge-to-surgery option for both left- and right-sided obstructive colorectal cancer.
• SEMS placement offers advantages in terms of reduced stoma rates and increased laparoscopic surgery rates compared to decompression tubes.
• The effectiveness of SEMS as a BTS strategy is comparable to decompression tubes regarding oncological outcomes.