Open surgery versus laparoscopic surgery after stent insertion for obstructive colorectal cancer

Enomoto, Toshiyuki; Saida, Yoshihisa; Takabayashi, Kazuhiro; Nagao, Sayaka; Takeshita, Emiko; Watanabe, Ryohei; Takahashi, Ayaka; Nakamura, Yoichi; Asai, Koji; Watanebe, Manabu; Nagao, Jirō; Kusachi, Shozo

doi:10.1007/s00595-016-1331-7

Cited by 16 publications

(15 citation statements)

References 18 publications

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“…Using a metallic stent for acute obstructive colorectal cancer has been well assessed and established as an effective procedure . SEMS were successfully inserted as a BTS in 97.1% of patients in our study.…”

Section: Discussionmentioning

confidence: 71%

“…Law et al reported that laparoscopic mobilization was not particularly difficult and the amount of blood loss was low . Several articles have reported that laparoscopic surgery after SEMS had short‐term outcomes that were better than or comparable to those of open surgery after SEM . We think that the stent‐laparoscopic procedure should be performed by skilled surgeons because the tumor size is larger than in non‐obstructive cancer, and edema or invasion around the tumor can make the procedure complicated.…”

Section: Discussionmentioning

confidence: 98%

“…As a BTS, SEMS can convert an emergency operation to an elective operation and enable single‐stage surgical resection without stoma creation . Several studies have reported that laparoscopic surgery after stent insertion can be performed as safely as open surgery . However, to date, few studies have assessed the influence of SEMS placement on laparoscopic procedures by comparing stent‐laparoscopy and regular laparoscopy for non‐obstructive colorectal cancer .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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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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“…Figure 1 shows our current therapeutic strategy for managing patients with obstructive colorectal cancers. The standard approach begins with colonic stenting, which is then followed by laparoscopic surgery independent of the location of the obstruction on the right or left side 29,30) .…”

Section: Transanal Drainage: Colonic Stent Versus Transanal Drainage mentioning

confidence: 99%

Current status of colonic stent for obstructive colorectal cancer in Japan; a review of the literature

Saida

2019

J Anus Rectum Colon

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Colorectal cancer is the most common cancer in Japan. Approximately 10%-20% of the patients with colorectal cancer present with large bowel obstruction, and those who present with malignant colonic obstruction (MCO) require urgent decompression because MCO can cause electrolytic fluid imbalance, colonic necrosis, bacterial translocation, and death. Placement of colonic stents (self-expandable metallic stents) for MCO is a major and standard endoscopic treatment that has been available since 2012 in Japan. This review presents the current conditions and future prospects of this procedure based on the literature. The current indication of colonic stent placement is malignant colorectal stenosis. One of the purposes of using stents is palliative treatment; further, its advantages over emergency surgery with colostomy include avoidance of colostomy, relief of obstruction, shorter hospitalization, and better quality of life. In addition, stent placement can also be used as a bridge to surgery since the duration of the hospitalization is shorter and postoperative complications, colostomy rates, and mortality rates are lower with elective than with emergency surgery. Although recent studies have reported low complication rates related to colonic stents, complications may still occur, highlighting the importance of good preparation, adequate staffing, backup systems, and informed consent. The current major problem related to colonic stents is the lack of evidence on patients' long-term prognoses for bridge to surgery purposes, awaiting the results of ongoing clinical research.

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“…Several previous studies demonstrated the superiority of SEMS over emergency surgery in terms of short-term outcomes (8)(9)(10). The feasibility of laparoscopic surgery after SEMS placement was also reported by several investigators (11)(12)(13). However, studies comparing the efficacy of SEMS and decompression tubes as a BTS are limited (14,15), as are studies comparing the usefulness of SEMS and decompression tubes as a bridge to laparoscopic surgery.…”

Section: Introductionmentioning

confidence: 87%

Successful single‐stage laparoscopic surgery using a preoperative self‐expanding metallic stent in patients with obstructive colorectal cancer

Hosono

Matsuda

Yamashita

et al. 2018

Asian J Endoscop Surgery

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Introduction Although a self‐expanding metallic stent (SEMS) or a transnasal or transanal decompression tube is sometimes used as a bridge to surgery in patients with obstructive colorectal cancer, the optimal decompression procedure to achieve successful laparoscopic surgery remains unclear. Methods Forty‐two patients with obstructive colorectal cancer who were preoperatively decompressed by using SEMS (the SEMS group, n = 20) or a decompression tube (the DT group, n = 22) between January 2010 and February 2017 were included in this retrospective study. Results In the SEMS group, 20 patients (100%) were able to eat and 17 patients (85%) were able to undergo total colonoscopy preoperatively, but no patients could do so in the DT group (P < 0.01 and P < 0.01, respectively). The serum albumin level increased in the time between admission and just before surgery in five patients in the SEMS groups (25%), whereas it decreased in all patients in the DT group (P = 0.037). Laparoscopic surgery was performed more frequently in the SEMS groups (19 patients, 95%) than in the DT group (13 patients, 59.1%) (P = 0.018). Primary anastomosis without stoma was also achieved more frequently in the SEMS groups (19 patients, 95%) than in the DT group (15 patients, 68.2%) (P = 0.047). Anastomotic leakage did not occur in the SEMS group, but it did occur in one patient in the DT group. The recurrence‐free survival rate did not differ between the groups (median follow‐up period: 21 months). Conclusion In patients with obstructive colorectal cancer, SEMS appears to be more effective than a decompression tube as a preoperative treatment to achieve successful laparoscopic resection without stoma.

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Open surgery versus laparoscopic surgery after stent insertion for obstructive colorectal cancer

Abstract: The patients who underwent laparoscopic resection had less blood loss, although no significant difference was found in postoperative morbidity or mortality. Thus, laparoscopic resection after stent insertion is a feasible and safe option for patients with obstructive colorectal cancer.

Cited by 16 publications

References 18 publications

Feasibility of laparoscopic surgery after stent insertion for obstructive colorectal cancer

Feasibility of laparoscopic surgery after stent insertion for obstructive colorectal cancer

Current status of colonic stent for obstructive colorectal cancer in Japan; a review of the literature

Successful single‐stage laparoscopic surgery using a preoperative self‐expanding metallic stent in patients with obstructive colorectal cancer

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