Long-term outcomes of colonic stent as a "bridge to surgery"for left-sided malignant large-bowel obstruction

Mora-López, Laura; Hidalgo, Marta; Falcó, Joan; Serra-Pla, Sh; Pallisera‐Lloveras, Anna; García-Nalda, Albert; Criado, Eva; Navarro‐Soto, Salvador; Serra‐Aracil, Xavier

doi:10.1016/j.suronc.2020.09.025

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…This procedure avoids emergency surgery by resolving obstruction to the passage of stool and obstructive enterocolitis. Colonic SEMS placement for BTS not only minimizes postoperative complications and the risk of colostomy compared with emergency surgery [ 1 – 3 ], but also provides similar surgical outcomes and long-term prognosis compared with non-obstructive colorectal cancer [ 4 ]. Another important problem with obstructive colorectal cancer is the possibility of synchronous colon cancers proximal to the primary lesion.…”

Section: Introductionmentioning

confidence: 99%

Importance of preoperative total colonoscopy and endoscopic resection after self-expandable metallic stent placement for obstructive colorectal cancer as a bridge-to-surgery

Itonaga,

Hamada,

Ihara

et al. 2023

BMC Gastroenterol

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Background and aim Colonic self-expandable metallic stent (SEMS) placement enables preoperative total colonoscopy (TCS) in patients with obstructive colorectal cancer. Following SEMS placement, it is possible to assess the presence or absence of synchronous proximal colon cancers and perform preoperative endoscopic resection (ER) for neoplastic lesions proximal to the primary lesion. The objective of this study was to determine the usefulness and safety of preoperative TCS and ER after SEMS placement in patients with obstructive colorectal cancer. Methods From April 2016 to March 2022, we enrolled 100 patients with obstructive colorectal cancer who underwent SEMS placement, including 86 patients who underwent preoperative TCS after SEMS placement. Complications associated with preoperative TCS and ER after SEMS placement and the characteristics of the neoplastic lesions were assessed. Results The success rate of SEMS placement as bridge-to-surgery was 98.0%; six patients had associated complications. Preoperative TCS was performed 8 (range: 1–30) days after SEMS placement. Four patients had synchronous advanced cancers. Nine non-advanced synchronous cancers, 116 adenomas, and 18 sessile-serrated lesions were treated by preoperative TCS and ER after SEMS placement. No procedure-related complications, namely stent migration, bleeding, and perforation were observed. Forty-five patients underwent follow-up TCS 1 year after surgery. Only one patient with submucosal invasive cancer required a second surgery. Conclusions Preoperative TCS and ER after SEMS placement was performed with no complications. This approach allows preoperative evaluation of the entire colon and the treatment of precancerous lesions. (240 words)

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Section: Introductionmentioning

confidence: 99%

Importance of preoperative total colonoscopy and endoscopic resection after self-expandable metallic stent placement for obstructive colorectal cancer as a bridge-to-surgery

Itonaga,

Hamada,

Ihara

et al. 2023

BMC Gastroenterol

View full text Add to dashboard Cite

show abstract

“…This procedure avoids emergency surgery by resolving obstruction to the passage of stool and obstructive enterocolitis. Colonic SEMS placement for BTS not only minimizes postoperative complications and the risk of colostomy compared with emergency surgery [1][2][3], but also provides similar surgical outcomes and long-term prognosis compared with non-obstructive colorectal cancer [4]. Another important problem with obstructive colorectal cancer is the possibility of synchronous colon cancers proximal to the primary lesion.…”

mentioning

confidence: 99%

Importance of preoperative total colonoscopy and endoscopic resection after self-expandable metallic stent placement for obstructive colorectal cancer as a bridge-to-surgery

Itonaga,

Hamada,

Ihara

et al. 2023

Preprint

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Background and Aim: Colonic self-expandable metallic stent (SEMS) placement enables preoperative total colonoscopy (TCS) in patients with obstructive colorectal cancer. Following SEMS placement, it is possible to assess the presence or absence of synchronous proximal colon cancers and perform preoperative endoscopic resection (ER) for neoplastic lesions proximal to the primary lesion. The objective of this study was to determine the usefulness and safety of preoperative TCS and ER after SEMS placement in patients with obstructive colorectal cancer.Methods From April 2016 to March 2022, we enrolled 100 patients with obstructive colorectal cancer who underwent SEMS placement, including 86 patients who underwent preoperative TCS after SEMS placement. Complications associated with preoperative TCS and ER after SEMS placement and the characteristics of the neoplastic lesions were assessed.Results The success rate of SEMS placement as bridge-to-surgery was 98.0%; six patients had associated complications. Preoperative TCS was performed 8 (range: 1–30) days after SEMS placement. Four patients had synchronous advanced cancers. Nine non-advanced synchronous cancers, 116 adenomas, and 18 sessile-serrated lesions were treated by preoperative TCS and ER after SEMS placement. No procedure-related complications, namely stent migration, bleeding, and perforation were observed. Forty-five patients underwent follow-up TCS 1 year after surgery. Only one patient with submucosal invasive cancer required a second surgery.Conclusions Preoperative TCS and ER after SEMS placement was performed with no complications. This approach allows preoperative evaluation of the entire colon and the treatment of precancerous lesions. (240 words)

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Short- and long-term outcomes after colonic stent insertion as a bridge to surgery in elderly colorectal cancer patients

Shiraishi,

Tominaga,

Ono

et al. 2023

Preprint

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Purpose: Colonic stents have been inserted as a bridge to surgery in patients with resectable colorectal cancer, allowing bowel decompression for systemic assessment and better preparation to avoid stoma construction. However, reports of short- and long-term prognoses for elderly patients remain limited. Methods: This retrospective study reviewed 175 consecutive patients who underwent colonic stent insertion for bowel obstruction followed by colorectal resection between 2016 and 2021. All cases were diagnosed with stage II/III pathologically. Patients were divided into those ³80 years old (Old, n=49) and those <80 years old (Young, n=126). Propensity score matching was applied to minimize selection biases, with 41 patients in each group matched and analyzed. Results: Before matching, performance status was poorer (performance status 3: 26.5% vs 4.8%; p<0.001), postoperative complication rate was higher (36.7% vs 17.5%; p=0.009), adjuvant chemotherapy rate was lower (8.2% vs 53.2%; p<0.001), and hospital stay was longer (16 vs 13 days; p<0.001) in the Old group. After matching, adjuvant chemotherapy rate was lower (9.8% vs 39.0%; p=0.003) and hospital stay was longer (14 vs 12 days; p=0.029) in the Old group. However, postoperative complication rates were comparable between groups (31.7% vs 26.8%; p=0.808), as were 5-year relapse-free survival rate (42.9% vs 68.8%; p=0.200), overall survival rate (66.3% vs 87.7%; p=0.081), and cancer-specific survival rate (68.2% vs 87.7%; p=0.129). Conclusions: Colorectal resection after colonic stent insertion is useful for elderly patients, with potential to reduce postoperative complication rates and achieve good long-term results with appropriate case selection.

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Long-term outcomes of colonic stent as a "bridge to surgery"for left-sided malignant large-bowel obstruction

Cited by 4 publications

References 28 publications

Importance of preoperative total colonoscopy and endoscopic resection after self-expandable metallic stent placement for obstructive colorectal cancer as a bridge-to-surgery

Importance of preoperative total colonoscopy and endoscopic resection after self-expandable metallic stent placement for obstructive colorectal cancer as a bridge-to-surgery

Importance of preoperative total colonoscopy and endoscopic resection after self-expandable metallic stent placement for obstructive colorectal cancer as a bridge-to-surgery

Short- and long-term outcomes after colonic stent insertion as a bridge to surgery in elderly colorectal cancer patients

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