Preoperative decompression for left-sided obstructive colorectal cancer: a comparative study between a stent and a decompression tube.

Abstract

Introduction: Stents and decompression tubes (DTs) are both commonly utilized for preoperative decompression in patients with left-sided obstructive colorectal cancer (OCRC). However, the comparative effectiveness and oncological safety of these 2 approaches remain uncertain.

Aim: The aim of this study was to compare clinical performance and long-term oncological outcomes of preoperative stent and DT insertion in patients with left-sided OCRC.

Materials and methods: The study included 87 consecutive patients, diagnosed with left-sided OCRC between January 2022 and December 2024. All patients underwent preoperative decompression using either a stent or a DT. Clinical decompression efficacy, surgical outcomes, and oncological parameters were compared between the groups.

Results: Among the 87 patients enrolled, 45 received a stent and 42, a DT. Technical success rates were similar between the groups (stent, 95.6% vs DT, 97.6%; P >0.99), as were clinical success rates (stent, 88.9% vs DT, 90.5%; P >0.99). Perforation occurred in 3 patients (6.7%) in the stent group and 1 participant (2.4%) in the DT group (P = 0.62). Primary anastomosis was achieved in 84.4% of the stent patients and 81% of the DT patients (P = 0.67). Median disease-free survival was 32 (21-43) months in the stent group and 34 (25-43) months in the DT group (P = 0.35), while median overall survival was 38 (29-47) and 39 (34-44) months, respectively (P = 0.53), with no apparent differences between the groups.

Conclusions: Both stent and DT insertion are safe and effective strategies for preoperative left-sided OCRC management. No significant differences in either short-term clinical outcomes or long-term oncological results were observed between the 2 methods.