Year 2018 / Volume 110 / Number 11
Original
The long-term recurrence rate and survival of obstructive left-sided colon cancer patients: a stent as a bridge to surgery

718-725

DOI: 10.17235/reed.2018.5077/2017

Araceli Ballestero Pérez, Juan Carlos García Pérez, Alfonso Muriel, Javier Die Trill, Eduardo Lobo,

Abstract
Background: a colonic stent as a bridge to elective surgery for left-sided malignant colonic obstruction is an alternative to the classical treatment. The aim of our study was to evaluate the recurrence rate as well as the morbidity and mortality of this treatment. Patients and methods: patients admitted to the Emergency Department with left-sided malignant colonic obstruction between June 2006 and January 2014 were analyzed in a retrospective observational study. Patients who underwent self-expanding metallic stent placement via endoscopy as a bridge to surgery were included. The observation period was performed until May 2017. Results: fifty-three patients were treated with a colonic stent as a bridge to surgery; nine patients died during the postoperative period. The deceased patients were more frequently male (100% in the deceased vs 62% in the non-deceased, p = 0.02), with a more advanced age (81.4 ± 5.1 vs 71.6 ± 10.8, p < 0.001), lower hemoglobin levels on admission (12.9 vs 13.6 p < 0.001), a greater number of leukocytes (12,918 vs 9,437, p < 0.001) and greater coagulopathy (INR 1.6 vs 1, p < 0.001). Eight patients had a distant relapse with a median disease-free survival of 19.1 months. The variables were compared according to the appearance of distant disease and the mean age was lower in patients with a recurrence (65.9 ± 11.3 vs 74.9 ± 9.9, p < 0.001). Conclusions: the results of the use of a stent as a bridge to curative surgery in patients with obstructive left colon cancer in our hospital is comparable to previous studies.
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References
1. Gorissen KJ, Tuynman JB, Fryer E, et al. Local recurrence after stenting for obstructing left-sided colonic cáncer. Br J Surg 2013;100:1805-9
2. Deans GT, Krukowski ZH, Irwin ST. Malignant obstruction of the left colon. Br J Surg 1994;81: 1270-1276.
3. Martínez-Santos C, Lobato RF, Fradejas JM, Pinto I, Ortega-Deballón p, Moreno-Azcoita M. Self-expandable stent before elective surgery vs. Emergency surgery for the treatment of malignant colorectal obstructions: comparison of primary anastomosis and morbidity rates. Dis Colon Rectum 2002; 45: 401-406.
4. Mealy K, O´Broin E, Donohue J, Tanner A, Keane FB. Reversible colostomy-what is the outcome? Dis Colon Rectum 1996;39: 1227-1231.
5. Rodrigues-Pinto E, Pereira P, Lopes S, et al. Outcome of endoscopic self-expandable metal stents in acute malignant colorectal obstruction at a tertiary center. Rev Esp Enferm Dig 2015;107(9):534-538.
6. Huang X, Lv B, Zhang S, et al. Preoperative colonic stents versus emergency surgery for acute left-sided malignant colonic obstruction: a meta-analysis. J Gastrointest Surg 2014;18:584-91.
7. Tung KL, Cheung HY, Ng LW, et al. Endo-laparoscopic approach versus conventional open surgery in the treatment of obstructing left-sided colon cancer: long-term folow-up of a randomized trial. Asian J Endosc Surg 2013:6;78-81.
8. Alcantara M, Serra-Aracil X, Falco J, et al. Prospective, controlled, randomized study of intraoperative colonic lavage versus stent placement in obstructive left-sided colonic cáncer. World J Surg 2011;35:1904-10.
9. Sloothaak D, van den Berg M, Dijkgraaf M, et al. Oncological outcome of malignant colonic obstruction in the Dutch Stent-In 2 Trial. Br J Surg 2014; 101:1751-1757.
10. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–213.
11. Dohmoto M. New method: endoscopic implantation of rectal stent in palliative treatment of malignant stenosis. Endosc Dig 1991; 3: 1507:1512.
12. Tejero E, Mainar A, Fernández L, Tolio R, De Gregorio MA. A new procedure for the treatment of colorectal neoplasic obstructions. Dis Colon Rectum 1994; 37:1158-1159.
13. Guo MG, Feng Y, Zheng Q et al. Comparison of self-expanding metal stents and urgent surgery for left-sided malignant colonic obstruction in elderly patients. Dig Dis Sci 2011; 56:2706-2710.
14. Sabbagh C, Browet F, Diouf M, et al. Is stenting as “a bridge to sur- gery” an oncologically safe strategy for the management of acute, left-sided, malignant, colonic obstruction? A comparative study with a propensity score analysis. Ann Surg 2013;258:107-15.
15. Pirlet IA, Slim K, Kwiatkowski F, et al. Emergency preoperative stenting versus surgery for acute left-sided malignant colonic obstruction: a multicenter randomized controlled trial. Surg Endosc 2011;25:1814-1821.
16. Van Hooft JF, Bemelman WA, Oldenburg B, et al. Colonic stenting versus emergency surgery for acute left-sided malignant colonic obstruction: a multicentre randomised trial. Lancet Oncol 2011;12:344-352.
17. Ghazal AH, El-Shazly WG, Bessa SS, et al. Colonic endolumenal stenting devices and elective surgery versus emergency subtotal/total colectomy in the management of malignant obstructed left colon carcinoma. J Gastrointest Surg 2013;17:1123-1129.
18. Ho KS, Quah HM, Lim JF, et al. Endoscopic stenting and elective surgery versus emergency surgery for left-sided malignant colonic obstruction a prospective randomized trial. Int J Colorectal Dis 2012;27:355-62.
19. Cheung HY, Chung CC, Tsang WW, et al. Endolaparoscopic approach vs conventional open surgery in the treatment of obstructing left- sided colon cancer: a randomized controlled trial. Arch Surg 2009;144:1127-1132.
20. Cennamo V, Luigiano C, Coccolini F, et al. Meta-analysis of random- ized trials comparing endoscopic stenting and surgical decompres- sion for colorectal cancer obstruction. Int J Colorectal Dis 2013;28: 855-63.
21. Cirocchi R, Farinella E, Trastulli S, et al. Safety and efficacy of endo- scopic colonic stenting as a bridge to surgery in the management of intestinal obstruction due to left colon and rectal cancer: a system- atic review and meta-analysis. Surg Oncol 2013;22:14-21.
22. De Ceglie A, Filiberti R, Baron TH, et al. A meta-analysis of endoscopic stenting as bridge to surgery versus emergency surgery for left-sided colorectal cancer obstruction. Crit Rev Oncol Hematol 2013;88: 387-403.
23. Tan CJ, Dasari BV, Gardiner K. Systematic review and meta-analysis of randomized clinical trials of self-expanding metallic stents as a bridge to surgery versus emergency surgery for malignant left-sided large bowel obstruction. Br J Surg 2012;99:469-76.
24. Ye GY, Cui Z, Chen L, et al. Colonic stenting vs emergent surgery for acute left-sided malignant colonic obstruction: a systematic review and meta-analysis. World J Gastroenterol 2012;18:5608-1
25. Zhang Y, Shi J, Shi B, et al. Self-expanding metallic stent as a bridge to surgery versus emergency surgery for obstructive colorectal cancer: a meta-analysis. Surg Endosc 2012;26:110-9.
26. Sagar J. Colorectal stents for the management of malignant colonic?obstructions. Cochrane Database Syst Rev 2011 Nov 9;(11):CD007378.
27. Maruthachalam K, Lah GE, sHENTON bk, Horgan AF. Tumour cell dissemination following endoscopic stent insertion. Br J Surg 2007;94: 1151-1154.
28. Kavanagh DO, Nolan B, Judge C, et al. A comparative Study Of short- and médium-term Outcomes Comparing Emergent surgery and Stenting as a Bridge to surgery in patients with acute malignant colonic obstruction. Dis Colon Rectum 2013; 56:433-440.
29. Knight AL, Trompetas V, Saunders MP, et al. Does stenting of left-sided colorectal cancer as a “bridge to surgery” adversely affect oncological outcomes? A comparison with non-obstructing elective left-sided colonic resections. Int J Colorectal Dis 2012;27:1509-14.
30. van Halsema EE, van Hooft JE, Small AJ, et al. Perforation in colorectal stenting: a meta-analysis and a search for risk factors. Gastrointest En- dosc/ENDOSC 2014;79:970-982 e7.
31. Van Hooft JE, van Halsema EE, Vanbiervliet G, et al. Self-expandable metal stents for obstructing colonic and extracolonic cáncer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Gastrointest Endosc 2014;46:990-1002.
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Ballestero Pérez A, García Pérez J, Muriel A, Die Trill J, Lobo E. The long-term recurrence rate and survival of obstructive left-sided colon cancer patients: a stent as a bridge to surgery. 5077/2017


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Publication history

Received: 23/05/2017

Accepted: 05/05/2018

Online First: 03/08/2018

Published: 30/10/2018

Article revision time: 341 days

Article Online First time: 437 days

Article editing time: 525 days


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