Long-term survival analysis after endoscopic stenting as a bridge to surgery for malignant colorectal obstruction: comparison with emergency diverting colostomy
The use of colorectal self-expanding metal stents (SEMS) as bridge therapy for malignant colorectal obstruction was first reported more than 20 years ago. However, its use remains controversial. Objective: In this study, we aimed to compare the long-term survival of patients with potentially resect...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2020-11-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322020000100301&tlng=en |
| _version_ | 1811329246791991296 |
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| author | Rodrigo Corsato Scomparin Bruno Costa Martins Luciano Lenz Luiza Haendchen Bento Carlos Sparapam Marques Adriana Safatle-Ribeiro Ulysses Ribeiro Jr Sergio Carlos Nahas Fauze Maluf-Filho |
| author_facet | Rodrigo Corsato Scomparin Bruno Costa Martins Luciano Lenz Luiza Haendchen Bento Carlos Sparapam Marques Adriana Safatle-Ribeiro Ulysses Ribeiro Jr Sergio Carlos Nahas Fauze Maluf-Filho |
| author_sort | Rodrigo Corsato Scomparin |
| collection | DOAJ |
| description | The use of colorectal self-expanding metal stents (SEMS) as bridge therapy for malignant colorectal obstruction was first reported more than 20 years ago. However, its use remains controversial. Objective: In this study, we aimed to compare the long-term survival of patients with potentially resectable malignant colorectal obstruction who had undergone colorectal SEMS placement and emergency surgery. Methods: This study was a retrospective analyses. Patients who received treatment between 2009 and 2017 were included. According to the eligibility criteria, 21 patients were included in the SEMS group and 67 patients were included in the surgical group.. Results: The majority of the patients in the SEMS group were female (57.1%), whereas the majority of those in the surgical group were male (53.7%). The median follow-up time was 60 months for both groups with the same interquartile range of 60 months. There was no difference in the overall survival rate (log rank p=0.873) and disease-free survival rate (log rank p=0.2821) in the five-year analysis. There was no difference in local recurrence rates (38.1% vs. 22.4%, p=0.14) or distant recurrence rates (33.3% vs. 50.7%, p=0.16) in the SEMS and the surgical groups. Technical and clinical success rates of endoscopic stenting were 95.3% and 85.7%, respectively. There were no immediate adverse events (AEs). Severe AEs included perforation (14.3%), silent perforation (4.7%), reobstruction (14.3%), and bleeding (14.3%). Mild AEs included pain (42.8%), tenesmus (9.5%), and incontinence (4.76%). The limitations of this study was retrospective and was conducted at a single center. Conclusions: No differences in disease-free and overall survival rates were observed in the five-year analysis of patients with resectable colorectal cancer who had undergone SEMS placement or colostomy for the treatment of malignant colorectal obstruction. Patients in the SEMS group had a higher rate of primary anastomosis and a lower rate of temporary colostomy than did those in the surgery group. |
| first_indexed | 2024-04-13T15:40:26Z |
| format | Article |
| id | doaj.art-fe5e226491874f03894361554d649800 |
| institution | Directory Open Access Journal |
| issn | 1980-5322 |
| language | English |
| last_indexed | 2024-04-13T15:40:26Z |
| publishDate | 2020-11-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-fe5e226491874f03894361554d6498002022-12-22T02:41:10ZengElsevier EspañaClinics1980-53222020-11-017510.6061/clinics/2020/e2046Long-term survival analysis after endoscopic stenting as a bridge to surgery for malignant colorectal obstruction: comparison with emergency diverting colostomyRodrigo Corsato Scomparinhttps://orcid.org/0000-0003-0779-0562Bruno Costa Martinshttps://orcid.org/0000-0002-0282-0753Luciano Lenzhttps://orcid.org/0000-0002-7945-8158Luiza Haendchen Bentohttps://orcid.org/0000-0003-2328-212XCarlos Sparapam Marqueshttps://orcid.org/0000-0003-4293-6301Adriana Safatle-Ribeirohttps://orcid.org/0000-0001-7686-8859Ulysses Ribeiro Jrhttps://orcid.org/0000-0003-1711-7347Sergio Carlos Nahashttps://orcid.org/0000-0002-2268-4146Fauze Maluf-Filhohttps://orcid.org/0000-0001-8875-420XThe use of colorectal self-expanding metal stents (SEMS) as bridge therapy for malignant colorectal obstruction was first reported more than 20 years ago. However, its use remains controversial. Objective: In this study, we aimed to compare the long-term survival of patients with potentially resectable malignant colorectal obstruction who had undergone colorectal SEMS placement and emergency surgery. Methods: This study was a retrospective analyses. Patients who received treatment between 2009 and 2017 were included. According to the eligibility criteria, 21 patients were included in the SEMS group and 67 patients were included in the surgical group.. Results: The majority of the patients in the SEMS group were female (57.1%), whereas the majority of those in the surgical group were male (53.7%). The median follow-up time was 60 months for both groups with the same interquartile range of 60 months. There was no difference in the overall survival rate (log rank p=0.873) and disease-free survival rate (log rank p=0.2821) in the five-year analysis. There was no difference in local recurrence rates (38.1% vs. 22.4%, p=0.14) or distant recurrence rates (33.3% vs. 50.7%, p=0.16) in the SEMS and the surgical groups. Technical and clinical success rates of endoscopic stenting were 95.3% and 85.7%, respectively. There were no immediate adverse events (AEs). Severe AEs included perforation (14.3%), silent perforation (4.7%), reobstruction (14.3%), and bleeding (14.3%). Mild AEs included pain (42.8%), tenesmus (9.5%), and incontinence (4.76%). The limitations of this study was retrospective and was conducted at a single center. Conclusions: No differences in disease-free and overall survival rates were observed in the five-year analysis of patients with resectable colorectal cancer who had undergone SEMS placement or colostomy for the treatment of malignant colorectal obstruction. Patients in the SEMS group had a higher rate of primary anastomosis and a lower rate of temporary colostomy than did those in the surgery group.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322020000100301&tlng=enMalignant Colonic ObstructionEmergency SurgeryColonic Endoscopic StentSEMSTumor Seeding |
| spellingShingle | Rodrigo Corsato Scomparin Bruno Costa Martins Luciano Lenz Luiza Haendchen Bento Carlos Sparapam Marques Adriana Safatle-Ribeiro Ulysses Ribeiro Jr Sergio Carlos Nahas Fauze Maluf-Filho Long-term survival analysis after endoscopic stenting as a bridge to surgery for malignant colorectal obstruction: comparison with emergency diverting colostomy Clinics Malignant Colonic Obstruction Emergency Surgery Colonic Endoscopic Stent SEMS Tumor Seeding |
| title | Long-term survival analysis after endoscopic stenting as a bridge to surgery for malignant colorectal obstruction: comparison with emergency diverting colostomy |
| title_full | Long-term survival analysis after endoscopic stenting as a bridge to surgery for malignant colorectal obstruction: comparison with emergency diverting colostomy |
| title_fullStr | Long-term survival analysis after endoscopic stenting as a bridge to surgery for malignant colorectal obstruction: comparison with emergency diverting colostomy |
| title_full_unstemmed | Long-term survival analysis after endoscopic stenting as a bridge to surgery for malignant colorectal obstruction: comparison with emergency diverting colostomy |
| title_short | Long-term survival analysis after endoscopic stenting as a bridge to surgery for malignant colorectal obstruction: comparison with emergency diverting colostomy |
| title_sort | long term survival analysis after endoscopic stenting as a bridge to surgery for malignant colorectal obstruction comparison with emergency diverting colostomy |
| topic | Malignant Colonic Obstruction Emergency Surgery Colonic Endoscopic Stent SEMS Tumor Seeding |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322020000100301&tlng=en |
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