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01-11-2016 | Original Article

Colonic stenting as a bridge to surgery for obstructive colorectal cancer: advantages and disadvantages

Authors: Naotsugu Haraguchi, Masataka Ikeda, Masakazu Miyake, Takuya Yamada, Yuko Sakakibara, Eiji Mita, Yuichiro Doki, Masaki Mori, Mitsugu Sekimoto

Published in: Surgery Today | Issue 11/2016

Abstract

Purpose

To clarify the advantages and disadvantages of stenting as a bridge to surgery (BTS) by comparing the clinical features and outcomes of patients who underwent BTS with those of patients who underwent emergency surgery (ES).

Methods

We assessed technical success, clinical success, surgical procedures, stoma formation, complications, clinicopathological features, and Onodera’s prognostic nutritional index (OPNI) in patients who underwent BTS and those who underwent ES.

Results

Twenty-six patients underwent stenting, which was successful in 22 (BTS group). The remaining four patients with unsuccessful stenting underwent emergency surgery. A total of 22 patients underwent emergency surgery (ES group). The rates of technical and clinical success were 85.0 and 81.0 %, respectively. The proportion of patients able to be treated by laparoscopic surgery (P = 0.0001) and avoid colostomy (P = 0.0042) was significantly higher in the BTS group. Although the incidence of anastomotic leakage in the two groups was not significantly different, it was significantly reduced by colonoscopic evaluation of obstructive colitis (P = 0.0251). The mean number of harvested lymph nodes (P = 0.0056) and the proportion of D3 lymphadenectomy (P = 0.0241) were significantly greater in the BTS group. Perineural invasion (PNI) was noted in 59.1 and 18.2 % of the BTS group and ES group patients, respectively (P = 0.0053). OPNI and serum albumin decreased significantly after stenting (P = 0.0084).

Conclusions

The advantages of stenting as a BTS were that it avoided colostomy and allowed for laparoscopic surgery and lymphadenectomy, whereas its disadvantage lay in the decreased PNI and OPNI levels. A larger study including an analysis of prognosis is warranted.

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Title: Colonic stenting as a bridge to surgery for obstructive colorectal cancer: advantages and disadvantages
Authors: Naotsugu Haraguchi
Masataka Ikeda
Masakazu Miyake
Takuya Yamada
Yuko Sakakibara
Eiji Mita
Yuichiro Doki
Masaki Mori
Mitsugu Sekimoto
Publication date: 01-11-2016
Publisher: Springer Japan
Published in: Surgery Today / Issue 11/2016
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-016-1333-5

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Colonic stenting as a bridge to surgery for obstructive colorectal cancer: advantages and disadvantages

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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