Effects of Colonic Stent as a Bridge to Surgery on Postoperative Short- and Long-term Outcomes: Comparison of Stent and Non-Stent Management in our Hospital

Abstract

Objectives: Colonic stent insertion as a bridge to surgery (BTS) has the advantage of avoiding emergency colostomy and is reported to have a lower postoperative complication rate than emergency resection or resection after stoma construction. Nevertheless, there is no consensus on the long-term prognosis; moreover, there are reports of stent insertion adversely affecting pathological findings. To clarify the influence of colorectal stent insertion on short-term postoperative results, pathological findings, and prognosis, we conducted this study. Methods: Patients who had undergone resection of the primary tumor for primary colorectal cancer at our hospital between January 2012 and December 2020 and had preoperative colorectal obstruction (Colorectal Obstruction Scoring System [CROSS]) 0-2 were included. Patient were divided into two groups: those with and without preoperative colonic stent insertion. The background, surgical course, histopathological findings, shortterm postoperative outcomes, and the prognosis of both groups were retrospectively examined. Results: There were 197 cases, 55 with preoperative colorectal stent insertion (stent group) and 142 without stent insertion (non-stent group). The rate of open surgery was significantly higher and postoperative hospital stay was longer in the non-stent group. There were no significant differences regarding histopathology findings, 3-year overall survival, and recurrences. Conclusions: The short-term postoperative results of patients with stent insertion were favorable, and it seems reasonable to continue stent insertion for the purpose of BTS; however, further study is required regarding prognosis.