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- Title
Clinical benefits and oncologic equivalence of self-expandable metallic stent insertion for right-sided malignant colonic obstruction.
- Authors
Ji, Woong; Um, Jun; Kwak, Jung; Kang, Dong; Kwak, Han; Kim, Jin; Kim, Seon; Lee, Sun-Il; Min, Byung-Wook; Sung, Nak; Ji, Woong Bae; Kwak, Jung Myun; Kang, Dong Woo; Kwak, Han Deok; Um, Jun Won; Sung, Nak Song; Kim, Seon Hahn
- Abstract
<bold>Background: </bold>The efficacy of stenting for right-sided malignant colonic obstruction is unknown. This study aimed to evaluate the safety, feasibility, and clinical benefits of self-expandable metallic stent insertion for right-sided malignant colonic obstruction.<bold>Methods: </bold>Clinical data from patients who underwent right hemicolectomy for right colon cancer from January 2006 to July 2014 at three Korea University hospitals were retrospectively reviewed. A total of 39 patients who developed malignant obstruction in the right-sided colon were identified, and their data were analyzed.<bold>Results: </bold>Stent insertion was attempted in 16 patients, and initial technical success was achieved in 14 patients (87.5 %). No stent-related immediate complications were reported. Complete relief from obstruction was achieved in all 14 patients. Twenty-five patients, including two patients who failed stenting, underwent emergency surgery. In the stent group, 93 % (13/14) of patients underwent elective laparoscopic surgery, and only one surgery was converted to an open procedure. All patients in the emergency group underwent emergency surgery within 24 h of admission. In the emergency group, only 12 % (3/25) of patients underwent laparoscopic surgery, with one surgery converted to an open procedure. All patients in both groups underwent either laparoscopy-assisted or open right/extended right hemicolectomy with primary anastomoses as the first operation. The operative times, retrieved lymph nodes, and pathologic stage did not differ between the two groups. Postoperative hospital stay (9.4 ± 3.4 days in the stent group vs. 12.4 ± 5.9 in the emergency group, p = 0.089) and time to resume oral food intake (3.2 ± 2.1 days in the stent group vs. 5.7 ± 3.4 in the emergency group, p = 0.019) were shorter in the stent group. And there were no significant differences in disease-free survival and overall survival between the two groups.<bold>Conclusions: </bold>Stent insertion appears to be safe and feasible in patients with right-sided colonic malignant obstruction. It facilitates minimally invasive surgery and may result in better short-term surgical outcomes.
- Subjects
SOUTH Korea; SURGICAL stents; COLON cancer patients; ONCOLOGIC surgery; LAPAROSCOPIC surgery; SURGICAL complications; PROGRESSION-free survival; COLECTOMY; COLON tumors; COMPARATIVE studies; LENGTH of stay in hospitals; BOWEL obstructions; LAPAROSCOPY; RESEARCH methodology; MEDICAL cooperation; MEDICAL emergencies; RESEARCH; ELECTIVE surgery; EVALUATION research; RETROSPECTIVE studies; SURGICAL blood loss
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2017, Vol 31, Issue 1, p153
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-016-4946-2