Comparison of Oncological and Perioperative Outcomes Between Self‐Expanding Metal Stents and Decompression Tubes for Stages II and III Obstructive Colorectal Cancer: A Retrospective Observational Study

Abstract

Background A bridge to surgery (BTS) using self‐expandable metallic stents (SEMSs) is becoming the primary treatment for obstructive colorectal cancer (OCRC). In Japan, intestinal decompression was usually performed using decompression tubes (DTs). However, few reports have compared the outcomes of SEMS and DTs as BTS. Therefore, we compared the treatment outcomes of SEMS and DTs for OCRC. Methods Data of 80 patients who underwent radical resection after endoscopic decompression for stage II or III OCRC between 2007 and 2021 were retrospectively analyzed. Patients were divided into two groups based on whether they received SEMS (n = 53) or DTs (n = 27). Results The clinical success rate of decompression was 96.2% and 88.9% in the SEMS and DT groups, respectively. Additionally, 96.2% of patients who received SEMS were able to resume their routine diet without stricture symptoms. The rate of stoma construction and incidence of postoperative complications were lower in the SEMS group (p < 0.005 and p < 0.01, respectively). The 3‐year relapse‐free survival rates were 71.9% and 51.2% in the SEMS and DT groups, respectively, which were not significantly different (p = 0.10). Conclusion BTS using SEMS might be an adequate treatment for stage II or III OCRC regardless of tumor location owing to the comparable oncological outcomes with DT and low perioperative complication rate.

Short-term and long-term oncologic outcomes of self-expandable metallic stent compared with tube decompression for obstructive colorectal cancer: a systematic review and meta-analysis

“…Twenty studies evaluated perioperative short-term outcomes [ 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 ]. Nine studies evaluated 3-year OS [ 18 19 20 21 22 26 30 31 32 ], and 12 studies evaluated 3-year RFS [ 10 11 12 13 14 15 17 18 21 22 23 24 ]. All studies determining OS and RFS evaluated patients with stage II or III colorectal cancers.…”

“…One study evaluated patients with right-sided obstructive colorectal cancers [ 31 ]. Eight studies evaluated patients with both right- and left-sided obstructive colorectal cancers [ 18 19 21 26 29 30 34 37 ]. Evaluation of methodological quality showed all studies scored 6 points on the NOS.…”