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International Journal of Colorectal Disease

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01-04-2020 | Endoscopy | Original Article

Quasi-elective left colectomy after endoscopic colon stenting for obstructive cancer yields comparable oncologic outcome to full-elective operation

Authors: Nicolò Tamini, Marco Ceresoli, Simone Aldè, Francesca Carissimi, Lorenzo Ripamonti, Luca Nespoli, Marco Dinelli, Marco Braga, Luca Gianotti

Published in: International Journal of Colorectal Disease | Issue 4/2020

Abstract

Purpose

Whether deferring surgery after endoscopic self-expandable metal stent (SEMS) placement for neoplastic stricture, and operating patients in a quasi-elective situation, may result in similar oncologic outcomes to elective operations is unclear. This study aimed to evaluate the disease-free survival (DFS) rates of patients who underwent an interval colon resection after SEMS placement or an elective operation with comparable cancer stages.

Methods

From a prospective dataset, we retrospectively selected patients with the following characteristics: (1) left-sided colon cancer and (2) cancer stage I to III. Exclusion criteria were as follows: (1) palliative surgery and (2) emergency operation. Then we stratified patients into two groups: (A) full-elective left colon resection and (B) quasi-elective left colon resection, defined as surgery performed after SEMS placement for obstructive colon cancer. DFS function was studied by the Kaplan-Meier method.

Results

After 1:2 matching based on cancer stage, 106 patients of the group A were compared with 53 patients of group B. In each group, there were 9.4% of stage I, 39.4% of stage II, and 50.9% of stage III patients. The rate of technical failure in SEMS placement was 3.8%. After a mean follow-up of 54 months, 16 (15.1%) patients in the full-elective groups and 10 (18.9%) in the quasi-elective group experience cancer recurrence (log rank = 0.588). DFS curve did not reach the median value.

Conclusions

SEMS placement with interval colon resection for obstructive neoplastic strictures seems to provide similar long-term oncologic outcomes to operations performed in an elective setting when a low rate of technical failure is achieved.

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Title: Quasi-elective left colectomy after endoscopic colon stenting for obstructive cancer yields comparable oncologic outcome to full-elective operation
Authors: Nicolò Tamini
Marco Ceresoli
Simone Aldè
Francesca Carissimi
Lorenzo Ripamonti
Luca Nespoli
Marco Dinelli
Marco Braga
Luca Gianotti
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Endoscopy
Colon Cancer
Colon Cancer
Published in: International Journal of Colorectal Disease / Issue 4/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-020-03519-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quasi-elective left colectomy after endoscopic colon stenting for obstructive cancer yields comparable oncologic outcome to full-elective operation

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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