Clinical benefits and oncologic equivalence of self-expandable metallic stent insertion for right-sided malignant colonic obstruction
- Authors
- Ji, Woong Bae; Kwak, Jung Myun; Kang, Dong Woo; Kwak, Han Deok; Um, Jun Won; Lee, Sun-Il; Min, Byung-Wook; Sung, Nak Song; Kim, Jin; Kim, Seon Hahn
- Issue Date
- Jan-2017
- Publisher
- SPRINGER
- Keywords
- Right colon cancer; Obstruction; Self-expandable metallic stent
- Citation
- SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, v.31, no.1, pp 153 - 158
- Pages
- 6
- Indexed
- SCI
SCIE
SCOPUS
- Journal Title
- SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
- Volume
- 31
- Number
- 1
- Start Page
- 153
- End Page
- 158
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/5366
- DOI
- 10.1007/s00464-016-4946-2
- ISSN
- 0930-2794
1432-2218
- Abstract
- 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. 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. 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. 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.
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Collections - 2. Clinical Science > Department of Colon and Rectal Surgery > 1. Journal Articles
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