Stent as bridge to surgery decreases postoperative complications without worsening oncological outcomes: retrospective unicentric cohort study and stent placement protocol.

Autor: Paniagua García-Señoráns M; Colorrectal Surgery Unit, Álvaro Cunqueiro Hospital, Vigo, Spain. marta.paniagua.garcia.senorans@sergas.es.; Hospital Álvaro Cunqueiro, Estrada de Clara Campoamor, 341, 36312, Vigo, Spain. marta.paniagua.garcia.senorans@sergas.es., Sánchez Santos R; Surgery Head of Service, Álvaro Cunqueiro Hospital, Vigo, Spain., Cano Valderrama Ó; Colorrectal Surgery Unit, Álvaro Cunqueiro Hospital, Vigo, Spain., Vigorita V; Colorrectal Surgery Unit, Álvaro Cunqueiro Hospital, Vigo, Spain., de Castro Parga ML; Gastroenterology Service, Álvaro Cunqueiro Hospital, Vigo, Spain., Cea Pereira S; Interventional Radiology Service, Álvaro Cunqueiro Hospital, Vigo, Spain., Rodríguez Fernández L; General Surgery Service, Álvaro Cunqueiro Hospital, Vigo, Spain., Moncada Iribarren E; Colorrectal Surgery Unit, Álvaro Cunqueiro Hospital, Vigo, Spain.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2023 Aug; Vol. 37 (8), pp. 6298-6307. Date of Electronic Publication: 2023 May 17.
DOI: 10.1007/s00464-023-10091-0
Abstrakt: Background: Even if the use of stent as bridge to surgery (BTS) for obstructive colon cancer was described long ago, there is still much controversy on their use. Patient recovery before surgery and colonic desobstruction are just some of the reasons to defend this management that can be found in several available articles.
Methods: This is a single-center, retrospective cohort study, including patients with obstructive colon cancer treated between 2010 and 2020. The primary aim of this study is to compare medium-term oncological outcomes (overall survival, disease-free survival) between stent as BTS and ES groups. The secondary aims are to compare perioperative results (in terms of approach, morbidity and mortality, and rate of anastomosis/stomas) between both groups and, within the BTS group, analyze whether there are any factors that may influence oncological outcomes.
Results: A total of 251 patients were included. Patients belonging to the BTS cohort presented a higher rate of laparoscopic approach, required less intensive care management, less reintervention, and less permanent stoma rate, when comparing with patients who underwent urgent surgery (US). There were not significant differences in terms of disease-free survival and overall survival between the two groups. Lymphovascular invasion negatively affected oncological results but was not related with stent placement.
Conclusion: The stent as a bridge to surgery is a good alternative to urgent surgery, which leads to a decrease in postoperative morbidity and mortality without significantly worsening oncological outcomes.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: