Stent as a bridge to surgery versus urgent surgery for malignant right colonic obstruction: A multicenter retrospective study

2021 ◽  
Author(s):  
Wei‐Gen Zeng ◽  
Meng‐Jia Liu ◽  
Zhi‐Xiang Zhou ◽  
Jun‐Jie Hu ◽  
Zhen‐Jun Wang
Keyword(s):  
Retrospective Study ◽  
Colonic Obstruction ◽  
Bridge To Surgery ◽  
Urgent Surgery

scholarly journals A comparative analysis of the treatment of patients with acute colonic obstruction obstructive tumor genesis

2017 ◽  
Vol 25 (3) ◽  
pp. 476-483 ◽  
Author(s):  
A. V. Shabunin ◽  
D. N. Grekov ◽  
A. V. Gugnin ◽  
I. Yu. Korsheva
Keyword(s):  
Retrospective Study ◽  
Comparative Analysis ◽  
Colonic Obstruction ◽  
Hemodynamic Instability ◽  
Metal Stents ◽  
Control Group ◽  
Endoscopic Stenting ◽  
Bridge To Surgery ◽  
Final Treatment ◽  
Colorectal Stenting

In a retrospective study, a comparative analysis of treatment of 509 patients with acute obstructive colonic obstruction, tumor genesis, which are made of different kinds of surgery (n=384) and stenting of the tumor stricture self-expanding metal stents (n=79). For statistical comparison of results concluded that the endoscopic stenting accompanied by fewer complications, a low mortality, reduces hospitalization time as compared to conventional operations. Stenting may be applicable for continuous decompression in patients with malignant strictures as the final treatment, as well as to the time of decompression in potentially resectable patients as the first stage of treatment («bridge to surgery»). In a retrospective study evaluated the results of clinical observation 509 patients from 2010 to October 2016 were carried out surgery for malignant obstruction of the colon. The first group included 79 patients who performed endoscopic stenting. These patients are the main group. A control group, consisting of two sub-groups, made up of 384 patients whom underwent surgery were performed. First subset patients (330 patients) performed a resection of the left colon departments to form a single-barrel colostomy (Hartmann type of operation), right-sided hemicolectomy with the formation ileotransverzoanastomosis; the second subgroup (54 patients) were formed colonies or ileostomy due to hemodynamic instability and/or the presence of unresectable tumors. We describe the results of the comparison of colorectal stenting and colostomy. The conclusion about the prospects of the use of colorectal stenting in patients with acute colonic obstruction obstructive tumor genesis.

scholarly journals Propensity score‐matched comparison of stenting as a bridge to surgery and emergency surgery for acute malignant left‐sided colonic obstruction

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuepeng Cao ◽  
Qing Chen ◽  
Zhizhan Ni ◽  
Feng Wu ◽  
Chenshen Huang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Emergency Surgery ◽  
Perineural Invasion ◽  
Cox Regression ◽  
Colonic Obstruction ◽  
Metal Stents ◽  
Bridge To Surgery ◽  
Cox Regression Analysis ◽  
Self Expanding Metal Stents

Abstract Background Bridge to elective surgery (BTS) using self-expanding metal stents (SEMSs) is a common alternative to emergency surgery (ES) for acute malignant left-sided colonic obstruction (AMLCO). However, studies regarding the long-term impact of BTS are limited and have reported unclear results. Methods A multicenter observational study was performed at three hospitals from April 2012 to December 2019. Propensity score matching (PSM) was introduced to minimize selection bias. The primary endpoint was overall survival. The secondary endpoints included surgical approaches, primary resection types, total stent-related adverse effects (AEs), surgical AEs, length of hospital stay, 30-day mortality and tumor recurrence. Results Forty-nine patients in both the BTS and ES groups were matched. Patients in the BTS group more often underwent laparoscopic resection [31 (63.3%) vs. 8 (16.3%), p < 0.001], were less likely to have a primary stoma [13 (26.5%) vs. 26 (53.1%), p = 0.007] and more often had perineural invasion [25 (51.0 %) vs. 13 (26.5 %), p = 0.013]. The median overall survival was significantly lower in patients with stent insertion (41 vs. 65 months, p = 0.041). The 3-year overall survival (53.0 vs. 77.2%, p = 0.039) and 5-year overall survival (30.6 vs. 55.0%, p = 0.025) were significantly less favorable in the BTS group. In multivariate Cox regression analysis, stenting (hazard ratio(HR) = 2.309(1.052–5.066), p = 0.037), surgical AEs (HR = 1.394 (1.053–1.845), p = 0.020) and pTNM stage (HR = 1.706 (1.116–2.607), p = 0.014) were positively correlated with overall survival in matched patients. Conclusions Self-expanding metal stents as “a bridge to surgery” are associated with more perineural invasion, a higher recurrence rate and worse overall survival in patients with acute malignant left-sided colonic obstruction compared with emergency surgery.

Does use of a metallic colon stent as a bridge to surgery modify the pathology data in patients with colonic obstruction? A case-matched study

2013 ◽  
Vol 27 (10) ◽  
pp. 3622-3631 ◽  
Author(s):  
Charles Sabbagh ◽  
Denis Chatelain ◽  
Nathalie Trouillet ◽  
François Mauvais ◽  
Sif Bendjaballah ◽  
...  
Keyword(s):  
Colonic Obstruction ◽  
Bridge To Surgery ◽  
Matched Study ◽  
Pathology Data
Sign in / Sign up

Export Citation Format

Share Document