Short- and long-term outcomes of a self-expandable metallic stent versus a transanal decompression tube for pathological stage II and III left-sided obstructive colorectal cancer: a retrospective observational study

Sato, Kentaro; Imaizumi, Ken; Kasajima, Hiroyuki; Kurushima, Michihiro; Umehara, Minoru; Tsuruga, Yosuke; Yamana, Daisuke; Obuchi, Keisuke; Sato, Aya; Nakanishi, Koji

doi:10.1007/s00595-021-02341-2

Cited by 10 publications

(13 citation statements)

References 34 publications

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“…Ueki et al found that patients who underwent BTS using SEMS had outcomes similar comparable to those who underwent elective surgery without SEMS in the long term [22]. In our previous report, the long-term oncological outcome of SEMS was better than that of transanal decompression tube [23]. Regarding the subgroup analysis in the OE-OB group, although peritoneal dissemination in patients with SEMS was somewhat higher than that in those without SEMS, the long-term outcomes were not worse.…”

Section: Discussionmentioning

confidence: 68%

Propensity score-matched analyses of postoperative oncological outcomes of colorectal cancer with versus without oncologic emergency: a single-center retrospective study

Imaizumi,

Kasajima,

Sato

et al. 2023

Preprint

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Background: While oncologic emergency in colorectal cancer present distinct challenges, the existing literature offers conflicting evidence on the long-term outcomes. Therefore, this study aimed to compare the postoperative oncological outcomes between patients with and without oncologic emergency. Methods: A retrospective evaluation was conducted on patients who had undergone radical surgery for primary stage II and III colorectal cancer between January 2012 and December 2020 at a single center. Patients were classified into three groups (oncologic non-emergency and oncologic emergency due to obstruction or perforation). Two of the three groups were paired using propensity score matching. The primary objective was to compare postoperative long-term outcomes between non-emergency and obstruction or perforation. The secondary objectives were to compare the outcomes between obstruction and perforation, identify the recurrence type among the three groups, and assess the outcomes for the subgroups based on obstruction and perforation features. Results: This study included 524 patients: 348, 140, and 36 patients in the non-emergency, obstruction, and perforation groups, respectively. After propensity score matching, the long-term outcomes of obstruction or perforation were significantly worse than those of non-emergency, whereas those of obstruction and perforation were not significantly different. Regarding recurrence type, peritoneal dissemination in obstruction and local recurrence in perforation were more common than in non-emergency. Conclusion: The long-term outcomes in oncologic emergency were worse than those in oncologic non-emergency, whereas obstruction and perforation outcomes were comparable. The establishment of therapeutic strategies and appropriate management of oncologic emergencies are important future issues.

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Section: Discussionmentioning

confidence: 68%

Propensity score-matched analyses of postoperative oncological outcomes of colorectal cancer with versus without oncologic emergency: a single-center retrospective study

Imaizumi,

Kasajima,

Sato

et al. 2023

Preprint

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“…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.…”

Section: Resultsmentioning

confidence: 99%

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

Ha,

Lee

2024

Ann Surg Treat Res

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Purpose Patients with obstructive colorectal cancer managed by emergency surgery show high morbidity, mortality, and stoma formation rates. Decompression modalities, including the self-expandable metallic stent (SEMS) and tube drainage (TD), have been used to improve surgical outcomes. However, there have been limited studies comparing the 2 modalities. We performed a meta-analysis on short- and long-term outcomes between SEMS and TD. Methods PubMed, EMBASE, Cochrane Library, and Google Scholar were searched. Data were pooled, and the overall effect size was calculated using random effect models. Outcome measures were perioperative short-term and 3-year survival outcomes. Results We included 20 nonrandomized studies that examined 2,047 patients in the meta-analysis. The meta-analysis showed SEMS had better short-term outcomes in clinical success rate, decompression-related complications, laparoscopic surgery rate, stoma formation rate, and postoperative complication rate with a relative risk (RR) of 0.36 (95% confidence interval [CI], 0.24–0.54; I 2 = 20%), 0.32 (95% CI, 0.20–0.50; I 2 = 0%), 0.47 (95% CI, 0.34–0.66; I 2 = 87%), 0.34 (95% CI, 0.24–0.49; I 2 = 52%), and 0.70 (95% CI, 0.54–0.89, I 2 = 28%), respectively. However, there was no significant difference between the 2 groups in 3-year overall survival (RR, 0.99; 95% CI, 0.77–1.27; I 2 = 0%). Conclusion Although the long-term oncologic impact of SEMS is still unclear compared with TD, the results of this meta-analysis may suggest that SEMS insertion can be performed more successfully and safely and may have benefits for short-term perioperative outcomes compared with TD. Further studies are warranted to provide more definitive survival results.

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“…The methods and indications for the SEMS placement in our hospital have been described in our previous article [18]. The SEMS procedures were performed by endoscopists.…”

Section: Methods and Devices Of Sems Placementmentioning

confidence: 99%

“…Patients with low rectal cancer were excluded from the cohort. OCRC diagnosis was confirmed through contrast enema, colonoscopy, and histological examination [18]. Decompression procedures were indicated for patients with a Col-oRectal Obstruction Scoring System (CROSS) score of 0-2 (Table 1).…”

Section: Study Design and Patientsmentioning

confidence: 99%

Comparison of Short-term Outcomes of a Self-expandable Metallic Stent as a Bridge to Laparoscopic Surgery between Right- and Left-sided Obstructive Colorectal Cancers: A Retrospective Observational Study

Sato

Imaizumi

Kasajima

et al. 2022

J Anus Rectum Colon

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Objectives: Few studies have compared the tumor-site-based postoperative short-term outcomes of a bridge to surgery using self-expandable metallic stents. This study compared the perioperative outcomes following stent placement between right-and left-sided obstructive colorectal cancers, focusing on patients undergoing laparoscopic surgery. Methods: This study included 127 patients with stage I-IV obstructive colorectal cancer (right-sided, n = 25 [19.7%]; left-sided, n = 102 [80.3%]) who underwent laparoscopic-assisted surgery following stent placement between May 2012 and September 2021. We compared the postoperative complication rates and the success rates of stent placement. Results:The clinical success rate was not significantly different (92% vs. 97.1%, P = 0.254). The rates of all-grade complications (36% vs. 16.7%, P = 0.05) and postoperative ileus or small-bowel obstruction (20% vs. 2%, P = 0.003) were significantly higher in the right-sided group. The rates of the Clavien-Dindo classification !III complications (8% vs. 6.9%, P = 1) and the median durations of postoperative hospital stay (8 days vs. 8 days, P = 1) were not significantly different. On multivariate analysis, right-sided colon cancer was an independent risk factor for postoperative ileus or small-bowel obstruction (odds ratio [OR]: 16.5, 95% confidence interval [CI]: 2.42-112, P = 0.004) but not for all grades of complications (OR: 2.63, 95% CI: 0.976-7.09, P = 0.056). Conclusions: Although the rates of clinical success, postoperative Clavien-Dindo classification !III severe complications, and postoperative hospital stay were comparable, the bridge to surgery following stent placement for right-sided obstructive colon cancer raises concerns about ileus or small-bowel obstruction.

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Short- and long-term outcomes of a self-expandable metallic stent versus a transanal decompression tube for pathological stage II and III left-sided obstructive colorectal cancer: a retrospective observational study

Cited by 10 publications

References 34 publications

Propensity score-matched analyses of postoperative oncological outcomes of colorectal cancer with versus without oncologic emergency: a single-center retrospective study

Propensity score-matched analyses of postoperative oncological outcomes of colorectal cancer with versus without oncologic emergency: a single-center retrospective study

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

Comparison of Short-term Outcomes of a Self-expandable Metallic Stent as a Bridge to Laparoscopic Surgery between Right- and Left-sided Obstructive Colorectal Cancers: A Retrospective Observational Study

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