Stent performance in obstructive left colon cancer. Unicentric and cross-sectional study

• Published in: Cirugia española (English ed.) 2019-08, Vol.97 (7), p.397-404
• Main Authors: Genzor Ríos, Sixto Javier, González-Nicolás Trebol, María Teresa, Aguirre Prat, Naira, Cantalejo Díaz, Miguel, Rodríguez Artigas, Juan Miguel, Medrano Peña, Joaquín, Zaragozano Guillén, Ramón, Miguelena Bobadilla, José María
• Format: Article
• Language: eng ; spa
• Subjects: Aged; Aged, 80 and over; Colonic Neoplasms - complications; Colonic Neoplasms - pathology; Colonic Neoplasms - surgery; Cross-Sectional Studies; Female; Humans; Intestinal Obstruction - etiology; Intestinal Obstruction - surgery; Laparoscopy - methods; Male; Middle Aged; Neoplasm Staging; Palliative Care - methods; Stents - adverse effects
• ISSN: 2173-5077
• DOI: 10.1016/j.ciresp.2019.04.018

To evaluate the efficacy, safety and clinical and oncological results of colonic stents in the initial therapeutic strategy of obstructive left colon cancer. Descriptive and ambispective study (2008-2018) of patients with clinical and radiological diagnosis of neoplastic obstruction of the left colon in whom a colonic stent was indicated, analyzing the following groups: palliative stent, stent as bridge to surgery and urgent surgery in case of stent failure or complications. The study included 208 patients. The technical and clinical success rates were 82.2% and 74.5%, respectively, with associated perforation in 4.3% of the sample. In 32.2%, the stent was placed as bridge to surgery, while 28.4% required urgent surgical intervention. The stent was placed with palliative intent in 39.4%. The proportion of laparoscopic surgery, oncological resection, primary anastomosis and lymph nodes resected were higher in patients undergoing elective surgery than in urgent surgery, with shorter postoperative stay and less severe postoperative morbidity and mortality. Stage II-III patients with oncological tumor resection who underwent elective surgery had increased survival compared to those who underwent urgent surgery (P=0.001). Initial treatment of neoplastic obstruction of the left colon with a stent is an effective strategy in elective surgery and avoids permanent colostomy in palliative patients, although complications or stent failure lead to urgent surgery in almost one-third of patients.