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- Title
Higher rate of perineural invasion in stent-laparoscopic approach in comparison to emergent open resection for obstructing left-sided colon cancer.
- Authors
Kim, Hye; Choi, Gyu-Seog; Park, Jun; Park, Soo; Jun, Soo
- Abstract
Purpose: We compared oncologic outcomes of laparoscopic surgery following self-expandable metallic stent (SEMS) insertion with one-stage emergency surgical treatment of obstructive left-sided colon and rectal cancers. Methods: From April 1996 to October 2007, 95 consecutive patients with left-sided obstructive colorectal cancers were included: 25 underwent preoperative stenting and elective laparoscopic surgery (SLAP) and 70 underwent emergency open surgery with intraoperative colon lavage (OLAV). Long-term oncologic outcomes were analyzed on an intention-to-treat basis. Results: There were no significant differences in baseline characteristics of patients between groups. Perineural invasion of the primary tumor was more frequent with SLAP (76 vs. 51.4 %, p = 0.033). The median follow-up was 51 months (range, 4-139 months). There were no significant differences between groups in 5-year overall survival rates (SLAP vs. OLAV, 67.2 vs. 61.6 %, p = 0.385). Five-year disease-free survival rates were also similar between groups (SLAP vs. OLAV, 61.2 vs. 60.0 %, p = 0.932). Conclusions: Laparoscopic surgery after SEMS was feasible and safe for patients with obstructive left-sided colorectal cancer, and oncologic outcomes were comparable to emergency open surgery with intraoperative colon lavage. These results support the continued use of SLAP in this setting. Further large-scale study is needed to investigate any clinical impact attached to the higher rates of perineural invasion observed in SLAP.
- Subjects
COLON cancer treatment; SURGICAL stents; CONDUCTION anesthesia; HEALTH outcome assessment; RECTAL cancer; INTRAOPERATIVE care
- Publication
International Journal of Colorectal Disease, 2013, Vol 28, Issue 3, p407
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-012-1556-x