Comparison of Long-Term Outcomes Between Emergency Surgery and Bridge to Surgery for Malignant Obstruction in Right-Sided Colon Cancer: A Multicenter Retrospective Study

Kye, Bong-Hyeon; Lee, Yoon Suk; Cho, Hyeon-Min; Kim, Jun-Gi; Oh, Seong-Taek; Lee, In Kyu; Kang, Won Kyung; Ahn, Chang-Hyeok; Lee, Sang Chul; Park, Jong-Kyung; Kim, Hyungjin

doi:10.1245/s10434-015-5053-7

Cited by 59 publications

(47 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, significantly more lymph nodes were harvested in the stent group. Contrary to our study, however, they did not find a significant difference in 30-day mortality and morbidity 22. A possible explanation for this discrepancy could be that they included considerable fewer patients than the current study and might have lacked power to demonstrate a significant difference.…”

Section: Discussioncontrasting

confidence: 99%

“…However, these data should be interpreted with caution, because all included studies in the systematic review were cohort studies. Kye et al22 recently published the first study directly comparing stent and acute resection as treatment options for MOPC. Similar to our outcomes, they found laparoscopic resection rate to be significantly higher following stent placement.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Population-Based Analysis of Three Treatment Modalities for Malignant Obstruction of the Proximal Colon: Acute Resection Versus Stent or Stoma as a Bridge to Surgery

Amelung

Consten

Siersema³

et al. 2016

Ann Surg Oncol

View full text Add to dashboard Cite

BackgroundMalignant obstruction of the proximal colon (MOPC) traditionally has been treated with acute resection. However, morbidity and mortality rates following these emergency surgeries are high. Initial bowel decompression by stent placement or stoma construction has been used for distal obstructions as an alternative approach. This study evaluated whether these alternative treatment strategies could be beneficial for patients with a MOPC as well.MethodsAll patients undergoing a colonic resection for a MOPC between January 2009 and December 2013 and who were registered in the Dutch Surgical Colorectal Audit were analyzed.ResultsFrom the 49,013 patients registered in the DSCA, 1860 (3.8 %) were selected for further analysis. Acute resection was performed in 1774 patients (95.4 %), 44 patients (2.4 %) were treated with initial decompression using stent placement and resection, and 42 patients (2.3 %) with stoma construction followed by resection. Thirty-day mortality was 8.8, 2.4, and 2.4 %, respectively. Mortality was significantly lower after a bridging strategy (stent or stoma) compared with acute resection (p = 0.04). Complications following the resection occurred in 39.6% in the acute resection group and in 27.3 and 31.7% in the stent and stoma group, respectively (p = 0.167).ConclusionsAcute resection was performed in the vast majority of patients with obstructive proximal colon cancer and resulted in a 40 % morbidity and 9 % mortality rate. A bridging strategy may be a valid alternative in some of these patients, because a significantly lower postoperative mortality rate was seen in a subgroup of patients initially treated with a stent or stoma.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Population-Based Analysis of Three Treatment Modalities for Malignant Obstruction of the Proximal Colon: Acute Resection Versus Stent or Stoma as a Bridge to Surgery

Amelung

Consten

Siersema³

et al. 2016

Ann Surg Oncol

View full text Add to dashboard Cite

show abstract

“…The study comparing SEMS and TDT for right‐sided OCRC demonstrated similar technical success and morbidity rates, but clinical success rate was significantly higher in the SEMS group owing to higher decompression efficacy . Kye et al reported that postoperative morbidity, 5‐year OS and DFS were comparable between the SEMS group and the emergency surgery group for right‐sided OCRC. In the present study, although the number was small (n = 15), 3‐year OS and DFS of SEMS‐inserted right‐sided OCRC cases were 100% and 82%, respectively.…”

Section: Discussionmentioning

confidence: 95%

“…Intestinal obstruction is one of the common presenting symptoms of colorectal cancer. Its incidence is reported as high as 30%, and obstructive colorectal cancer (OCRC) accounted for 85% of colonic emergency . Emergency surgery is usually indicated and this is associated with increased morbidity, mortality, and stoma rate compared to elective surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the long‐term outcomes of the self‐expandable metallic stent and transanal decompression tube for obstructive colorectal cancer

Sato

Oikawa

Kakita

et al. 2019

Annals of Gastroent Surgery

View full text Add to dashboard Cite

Aim Endoscopic decompression using the self‐expandable metallic colonic stent (SEMS) or transanal decompression tube (TDT) can convert emergency surgery into elective one‐stage surgery for obstructive colorectal cancer (OCRC). The aim of the present study was to clarify the effect of SEMS and TDT on long‐term oncological outcomes. Methods We retrospectively analyzed 76 consecutive pathological stage II and III OCRC patients who were inserted with SEMS or TDT as a bridge to curative surgery between 2009 and 2018. Results There were 53 SEMS cases and 23 TDT cases. The tumor was located in the left colon in 58 cases and in the right colon in 18 cases. The interval between the decompression and the surgery was 16.5 days in the SEMS group and 13.0 days in the TDT group (P = 0.09). Technical and clinical success rates were 100% and 100% for SEMS, and 95% and 91% for TDT, respectively. Stoma was created in four patients in the SEMS group, and in five in the TDT group (P = 0.08). Three‐year overall survival rates of the SEMS and TDT groups were 82% and 86% (P = 0.94), and disease‐free survival rates were 68% and 62% (P = 0.79), respectively. The recurrence pattern was not significantly different. Conclusion This study found no statistically significant differences between the effects of SEMS and TDT for OCRC as a bridge to surgery on long‐term outcomes.

show abstract

“…2 Nevertheless, there are some reasons they would decide on the placement of SEMS for obstructing colon cancer: medically inoperable patients' condition, to avoid multiple staged surgeries (especially for left-sided colon obstruction) and post-operative morbidity, to provide enough preoperative resuscitation and so on. 3 In other words, the preference of SEMS would be intended to achieve favourable perioperative outcomes.…”

Section: Dear Editormentioning

confidence: 99%

Response to Re: Outcome of bridge to surgery stenting for obstructive left colon cancer

Kye

Kim

Kang

2017

ANZ Journal of Surgery

Self Cite

View full text Add to dashboard Cite

Comparison of Long-Term Outcomes Between Emergency Surgery and Bridge to Surgery for Malignant Obstruction in Right-Sided Colon Cancer: A Multicenter Retrospective Study

Cited by 59 publications

References 19 publications

A Population-Based Analysis of Three Treatment Modalities for Malignant Obstruction of the Proximal Colon: Acute Resection Versus Stent or Stoma as a Bridge to Surgery

A Population-Based Analysis of Three Treatment Modalities for Malignant Obstruction of the Proximal Colon: Acute Resection Versus Stent or Stoma as a Bridge to Surgery

Comparison of the long‐term outcomes of the self‐expandable metallic stent and transanal decompression tube for obstructive colorectal cancer

Response to Re: Outcome of bridge to surgery stenting for obstructive left colon cancer

Contact Info

Product

Resources

About