Colonic stenting as a bridge to surgery versus emergency surgery for malignant colonic obstruction: results of a multicentre randomised controlled trial (ESCO trial)

Arezzo, Alberto; Balagué, Carmen; Targarona, Eduardo M.; Borghi, Felice; Giraudo, Giorgio; Ghezzo, Luigi; Arroyo, Antonio; Sola-Vera, Javier; Paolis, Paolo De; Bossotti, M; Bannone, Elisa; Forcignanò, Edoardo; Bonino, Marco Augusto; Passera, Roberto; Morino, Mario

doi:10.1007/s00464-016-5362-3

Cited by 153 publications

(173 citation statements)

References 16 publications

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“…Stenting might not worsen long-term oncological outcomes if the stent can be placed with a low risk of perforation, as in the present study. Indeed, in a relatively large RCT that was published recently, there were no differences in oncological outcomes with respect to overall survival (OS) and disease-free survival (DFS) between the two groups, although the follow-up period of 3 years was quite short [39]. JCSSPRG plans to start an RCT to compare a group undergoing early surgery after fasting and a group undergoing elective surgery after colonic stenting in patients with CROSS 1 or 2.…”

Section: Discussionmentioning

confidence: 99%

Self-expandable metallic stenting as a bridge to surgery for malignant colorectal obstruction: pooled analysis of 426 patients from two prospective multicenter series

Tomita

Saito²,

Makimoto

et al. 2018

Surg Endosc

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Section: Discussionmentioning

confidence: 99%

Self-expandable metallic stenting as a bridge to surgery for malignant colorectal obstruction: pooled analysis of 426 patients from two prospective multicenter series

Tomita

Saito²,

Makimoto

et al. 2018

Surg Endosc

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“…In particular, the aim of the meta-analysis was to update the current evidence in this field, including a recently concluded multicentre randomized controlled trial by Arezzo et al [8]. …”

Section: Introductionmentioning

confidence: 99%

Endoscopic Stenting as Bridge to Surgery versus Emergency Resection for Left-Sided Malignant Colorectal Obstruction: An Updated Meta-Analysis

Allievi

Ceresoli

Fugazzola

et al. 2017

International Journal of Surgical Oncology

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Introduction Emergency resection represents the traditional treatment for left-sided malignant obstruction. However, the placement of self-expanding metallic stents and delayed surgery has been proposed as an alternative approach. The aim of the current meta-analysis was to review the available evidence, with particular interest for the short-term outcomes, including a recent multicentre RCT. MethodsWe considered randomized controlled trials comparing stenting as a bridge to surgery and emergency surgery for the management of left-sided malignant large bowel obstruction, performing a systematic review in MEDLINE, PubMed database, and the Cochrane libraries. ResultsWe initially identified a total of 2543 studies. After the elimination of duplicates and the screening of titles and abstracts, seven studies, for a total of 448 patients, were considered. The current meta-analysis revealed no difference in the mortality rate between the stent group and the emergency surgery group; the postoperative complication rate (37.84% versus 54.87%, P = 0.02), the stoma rate (28.8% versus 46.02%, P < 0.0001), and the incidence of wound infection (8.11% versus 15.49%, P = 0.01) were reduced after stent as a bridge to surgery. Conclusion Colonic stenting as a bridge to surgery appears to be a safe approach to malignant large bowel obstruction. Possible advantages of this treatment can be identified in a reduced incidence of postoperative complications and a lower stoma rate. Further RCTs considering long-term outcomes and cost-effectiveness analysis are needed.

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“…The main treatment for malignant colonic obstruction includes emergency surgery, a transanal or transnasal ileus tube, or a colonic stent. Emergency surgery for the obstruction is associated with higher morbidity and mortality than elective surgery, and the creation of a stoma is necessary in most cases .…”

Section: Introductionmentioning

confidence: 99%

Feasibility of laparoscopic surgery after stent insertion for obstructive colorectal cancer

Shimizu

Yamazaki

Ohtsuka

et al. 2017

Asian J Endoscop Surgery

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Colonic stenting as a bridge to surgery versus emergency surgery for malignant colonic obstruction: results of a multicentre randomised controlled trial (ESCO trial)

Abstract: Our findings indicate that the two treatment strategies are equivalent. No difference in oncologic outcome was found at a median follow-up of 36 months. The significantly lower stoma rate noted in the SBTS group argues in favour of the SBTS procedure when performed in expert hands.

Cited by 153 publications

References 16 publications

Self-expandable metallic stenting as a bridge to surgery for malignant colorectal obstruction: pooled analysis of 426 patients from two prospective multicenter series

Self-expandable metallic stenting as a bridge to surgery for malignant colorectal obstruction: pooled analysis of 426 patients from two prospective multicenter series

Endoscopic Stenting as Bridge to Surgery versus Emergency Resection for Left-Sided Malignant Colorectal Obstruction: An Updated Meta-Analysis

Feasibility of laparoscopic surgery after stent insertion for obstructive colorectal cancer

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