Outcomes of Patients with Left-Sided Obstructive Colorectal Cancer: Comparison between Self-Expandable Metallic Stent and Other Treatment Methods

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2022-04-22 DOI:10.1159/000524645

A. Kondo, K. Kumamoto, H. Kobara, Teruya Nagahara, M. Wato, M. Shibatoge, Takuya Minato, Tsutomu Masaki, K. Okano

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引用次数: 1

Abstract

Introduction: This multi-institutional retrospective study aimed to evaluate the efficacy of preoperative self-expandable metallic stent (SEMS) placement for patients with left-sided obstructive colorectal cancer (OCRC). Methods: Overall, 520 consecutive patients who received treatment for OCRC were enrolled. Of these, the data of 253 patients who underwent primary tumour resection for left-sided OCRC were reviewed. The short- and long-term outcomes were compared between the SEMS group and other three groups: transanal decompression tube (TaDT), decompressing stoma (DS), and emergency resection (ER). Results: The SEMS group had a higher frequency of laparoscopic surgery (p < 0.001), lesser frequency of postoperative stoma (p < 0.001), and more dissected lymph nodes (p < 0.001) than the other groups. Moreover, the SEMS group had shorter postoperative hospital stays than the TaDT, DS, and ER groups (p = 0.005, p = 0.037, and p < 0.001, respectively). The Kaplan-Meier survival curves of recurrence-free survival and overall survival did not differ significantly between the SEMS group and the other three groups in patients with stage II and III diseases. Discussion/Conclusion: Elective surgery after SEMS placement may improve short-term outcomes compared to other treatment strategies, with similar long-term outcomes.

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左侧梗阻性结直肠癌患者的预后:自膨胀金属支架与其他治疗方法的比较

本多机构回顾性研究旨在评估左侧梗阻性结直肠癌(OCRC)患者术前放置自膨胀金属支架(SEMS)的疗效。方法:总共入组520例连续接受OCRC治疗的患者。其中，我们回顾了253例因左侧OCRC接受原发肿瘤切除的患者的资料。比较SEMS组与其他三组(经肛门减压管(TaDT)、减压造口(DS)和急诊切除(ER))的短期和长期结果。结果:SEMS组腹腔镜手术发生率高于对照组(p < 0.001)，术后造瘘发生率低于对照组(p < 0.001)，淋巴结清扫率高于对照组(p < 0.001)。此外，SEMS组术后住院时间短于TaDT、DS和ER组(p = 0.005、p = 0.037和p < 0.001)。在II期和III期疾病患者中，SEMS组与其他三组无复发生存期和总生存期的Kaplan-Meier生存曲线无显著差异。讨论/结论:与其他治疗策略相比，SEMS放置后的择期手术可以改善短期预后，并具有相似的长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.