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Short‑ and long‑term outcomes of self‑expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction

  • Authors:
    • Yusuke Yagawa
    • Shin-Ei Kudo
    • Hideyuki Miyachi
    • Yuichi Mori
    • Masashi Misawa
    • Yuta Sato
    • Koki Kudo
    • Tomoyuki Ishigaki
    • Katsuro Ichimasa
    • Toyoki Kudo
    • Takemasa Hayashi
    • Kunihiko Wakamura
    • Toshiyuki Baba
    • Fumio Ishida
  • View Affiliations / Copyright

    Affiliations: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224‑8503, Japan
    Copyright: © Yagawa et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 63
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    Published online on: January 29, 2021
       https://doi.org/10.3892/mco.2021.2225
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Abstract

The European Society of Gastrointestinal Endoscopy does not recommend self‑expanding metal stent (SEMS) placement as a bridge to surgery (BTS) for malignant colorectal obstruction (MCRO). However, no universally accepted consensus has been determined. The present study aimed to evaluate the short‑ and long‑term outcomes of SEMS placement vs. emergency surgery (ES) for MCRO. Surgical resection of colorectal cancer was performed in 3,840 patients between April 2001 and June 2016. Of these, 93 patients had MCRO requiring emergency decompression. Only patients in whom the colorectal lesion was ultimately resected were included; thus, the present study included 62 patients treated with MCRO via SEMS placement as a BTS (n=25) or via ES (n=37). The rates of laparoscopic surgery, primary anastomosis, stoma formation, lymph node dissection, adverse events, 30‑day mortality and disease‑free survival were evaluated. The clinical success rate of SEMS placement was 92.0% (23/25). Compared with the ES group, the SEMS group had higher rates of laparoscopic surgery (68.0 vs. 2.7%; P<0.001) and primary anastomosis (88.0 vs. 51.4%; P=0.003), a greater number of dissected lymph nodes (30 vs. 18; P=0.001), and lower incidences of stoma formation (24.0 vs. 67.6%; P=0.002) and overall adverse events (24.0 vs. 62.2%; P=0.004). The 30‑day mortality and disease‑free survival of the SEMS group were not significantly different to that of the ES group (0 vs. 2.7%; P=1.000; log‑rank test; P=0.10). In conclusion, as long as adverse events such as perforation are minimized, SEMS placement as a BTS could be a first treatment option for MCRO. The present study is registered in the University Hospital Medical Network Clinical Trials Registry (UMIN R000034868).
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Copy and paste a formatted citation
Spandidos Publications style
Yagawa Y, Kudo S, Miyachi H, Mori Y, Misawa M, Sato Y, Kudo K, Ishigaki T, Ichimasa K, Kudo T, Kudo T, et al: Short‑ and long‑term outcomes of self‑expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction. Mol Clin Oncol 14: 63, 2021.
APA
Yagawa, Y., Kudo, S., Miyachi, H., Mori, Y., Misawa, M., Sato, Y. ... Ishida, F. (2021). Short‑ and long‑term outcomes of self‑expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction. Molecular and Clinical Oncology, 14, 63. https://doi.org/10.3892/mco.2021.2225
MLA
Yagawa, Y., Kudo, S., Miyachi, H., Mori, Y., Misawa, M., Sato, Y., Kudo, K., Ishigaki, T., Ichimasa, K., Kudo, T., Hayashi, T., Wakamura, K., Baba, T., Ishida, F."Short‑ and long‑term outcomes of self‑expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction". Molecular and Clinical Oncology 14.4 (2021): 63.
Chicago
Yagawa, Y., Kudo, S., Miyachi, H., Mori, Y., Misawa, M., Sato, Y., Kudo, K., Ishigaki, T., Ichimasa, K., Kudo, T., Hayashi, T., Wakamura, K., Baba, T., Ishida, F."Short‑ and long‑term outcomes of self‑expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction". Molecular and Clinical Oncology 14, no. 4 (2021): 63. https://doi.org/10.3892/mco.2021.2225
Copy and paste a formatted citation
x
Spandidos Publications style
Yagawa Y, Kudo S, Miyachi H, Mori Y, Misawa M, Sato Y, Kudo K, Ishigaki T, Ichimasa K, Kudo T, Kudo T, et al: Short‑ and long‑term outcomes of self‑expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction. Mol Clin Oncol 14: 63, 2021.
APA
Yagawa, Y., Kudo, S., Miyachi, H., Mori, Y., Misawa, M., Sato, Y. ... Ishida, F. (2021). Short‑ and long‑term outcomes of self‑expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction. Molecular and Clinical Oncology, 14, 63. https://doi.org/10.3892/mco.2021.2225
MLA
Yagawa, Y., Kudo, S., Miyachi, H., Mori, Y., Misawa, M., Sato, Y., Kudo, K., Ishigaki, T., Ichimasa, K., Kudo, T., Hayashi, T., Wakamura, K., Baba, T., Ishida, F."Short‑ and long‑term outcomes of self‑expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction". Molecular and Clinical Oncology 14.4 (2021): 63.
Chicago
Yagawa, Y., Kudo, S., Miyachi, H., Mori, Y., Misawa, M., Sato, Y., Kudo, K., Ishigaki, T., Ichimasa, K., Kudo, T., Hayashi, T., Wakamura, K., Baba, T., Ishida, F."Short‑ and long‑term outcomes of self‑expanding metallic stent placement vs. emergency surgery for malignant colorectal obstruction". Molecular and Clinical Oncology 14, no. 4 (2021): 63. https://doi.org/10.3892/mco.2021.2225
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