Effect of self-expandable metal stent on morbidity and mortality and oncological prognosis in malignant colonic obstruction: retrospective analysis of its use as curative and palliative treatment

Introduction Acute gastrointestinal obstruction due to colorectal cancer occurs in 7–30% of cases and is an abdominal emergency that requires urgent decompression. The safety and oncological effect of self-expandable metal stents (SEMS) in these patients remains controversial. This study aimed to ev...

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Bibliographic Details
Published in:International journal of colorectal disease 2022-02, Vol.37 (2), p.475-484
Main Authors: Recuenco, Carlos Bustamante, Septiem, Javier García, Díaz, Javier Arias, Vasallo, Israel John Thuissard, de la Madriz, Alejandro Andonaegui, Carneros, Virginia Jiménez, Rodríguez, Jose Luis Ramos, Navalón, José María Jover, Miramón, Francisco Javier Jiménez
Format: Article
Language:English
Subjects:
Analysis
Anastomosis
Colonic Neoplasms - complications
Colonic Neoplasms - surgery
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms
Decompression
Gastroenterology
Gastrointestinal diseases
Hepatology
Humans
Implants
Internal Medicine
Intestinal obstruction
Intestinal Obstruction - etiology
Intestinal Obstruction - surgery
Laparoscopy
Medical prognosis
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Morbidity
Mortality
Original Article
Palliation
Palliative Care
Patient outcomes
Patients
Proctology
Prognosis
Retrospective Studies
Safety and security measures
Self Expandable Metallic Stents - adverse effects
Stent (Surgery)
Stents
Stents - adverse effects
Surgery
Survival
Treatment Outcome
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Summary:Introduction Acute gastrointestinal obstruction due to colorectal cancer occurs in 7–30% of cases and is an abdominal emergency that requires urgent decompression. The safety and oncological effect of self-expandable metal stents (SEMS) in these patients remains controversial. This study aimed to evaluate its impact on these variables and compare it with that of emergency surgery (ES). Methods Descriptive, retrospective and single-centre study, performed between 2008 and 2015, with follow-up until 2017. One hundred eleven patients with diagnosis of left malignant colonic obstruction were included and divided according to the treatment received: stent as bridge to surgery (SBTS group: 39), palliative stent (PS group: 30) and emergency surgery with curative (ECS group: 34) or palliative intent (EPS group: 8). Treatment was decided by the attending surgeon in charge. Results Technical and clinical general success rates for colorectal SEMS were 95.7% and 91.3%, respectively, with an associated morbimortality of 23.2%, which was higher in the PS group ( p  = 0.002). The SBTS group presented a higher laparoscopic approach and primary anastomosis ( p  
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-021-04081-8