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International Journal of Colorectal Disease

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01-04-2019 | Enterostomy | Original Article

Colonic stenting as a bridge to surgery in malignant large bowel obstruction: oncological outcomes

Authors: N. E. Donlon, M. E. Kelly, F. Narouz, P. H. McCormick, J. O. Larkin, B. J. Mehigan

Published in: International Journal of Colorectal Disease | Issue 4/2019

Abstract

Introduction

Stenting of obstructing colorectal cancers obviates the need for emergency surgery, reducing initial morbidity and mortality rate associated with emergency surgery and facilitates full staging of the neoplastic process with an opportunity to optimize the patient for surgery. Some recent publications have suggested however that this approach may be associated with higher local recurrence rates. We examined our outcomes following colonic stenting as a bridge to resection.

Methods

A database was reviewed (2006–2018) of patients presenting with acute colorectal obstruction that proceeded to endoscopic stenting. We assessed the bridge to surgery strategy, its success, complication rate, and impact on recurrence and survival.

Results

Of a total of 103 patients who presented with acute malignant large bowel obstruction over this time period, 26 patients had potentially curable disease at presentation and underwent stenting as a bridge to surgery. The technical success rate for stenting in those managed as a bridge to surgery was 92% (n = 24/26) with 7.69% (n = 2/26) having a complication. There was one stent-related perforation. Median follow-up of this cohort was 31 months, with a 5-year overall survival of 53.5%.

Conclusion

Colorectal stenting as a bridge to resection is a successful management strategy for those presenting with obstructing colorectal obstruction. Selective use is associated with lower rates of stoma formation, greater rates of laparoscopic resections with low complication rates, and acceptable oncological outcomes.

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Title: Colonic stenting as a bridge to surgery in malignant large bowel obstruction: oncological outcomes
Authors: N. E. Donlon
M. E. Kelly
F. Narouz
P. H. McCormick
J. O. Larkin
B. J. Mehigan
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Keywords: Enterostomy
Enterostomy
Colorectal Cancer
Colorectal Cancer
Published in: International Journal of Colorectal Disease / Issue 4/2019
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-019-03239-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Colonic stenting as a bridge to surgery in malignant large bowel obstruction: oncological outcomes

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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