大腸ステント留置術の術前ブリッジ療法としての安全性と有効性：後向き研究

Objective The objective of this study was to establish the safety and efficacy of stenting as a bridge to surgery (BTS) by comparing outcomes in patients who underwent stenting followed by surgery with those who proceeded directly to surgery. Methodology Data were collected retrospectively for all patients who presented with left-sided malignant colonic obstruction between April 1, 2021, and December 31, 2024, at the Surgical Oncology Department, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Peshawar, Pakistan. In this observational, non-randomized study, all patients of either gender aged 18 years or older with biopsy-proven left-sided colon cancer were included. Patients with metastatic disease were excluded. Results A total of 29 patients were included in this study, out of which 22 (75.9%) underwent stenting as a BTS, while seven (24.1%) went straight to surgery without stenting. The most frequent procedure in the stenting group was laparoscopic anterior resection with anastomosis (n = 14); while, in the non-stenting group, Hartmann's procedure (n = 7) was predominant. Overall, seven patients (24.1%) developed perforation; however, the difference in perforation rates between the two groups was not statistically significant (p = 0.753). Stoma formation was significantly lower in the stenting group (p = 0.018). Key perioperative parameters did not show any statistically significant changes between the stented and non-stented groups. Conclusions Colonic stenting is a safe and viable option in patients with left-sided malignant colonic obstruction to decompress the bowel, which results in significantly higher rates of primary anastomosis and avoidance of stoma.