Study On The Benefts Of Self-expandable Metallic Stent As A Bridge To Surgery For Colorectal Cancers With Obstruction

Objective:The study was aimed to evaluate the Safety and efficacy of self-expanding metal stent(SEMS)implantation as a preoperative bridge for the treatment of colorectal cancer with obstruction and to to explore its benefits in different sites.Methods:We prospectively reviwed these patients who were diagnosed as obstructive colorectal cancers(OCRC)at our hospital from January 2014 to December 2018.These patients received emergency surgery or elective surgical treatment after self-expanding metal stent implantation.We assessed short-term efficacy of the SEMS group and the emergency surgery(ES)group according to the tumor location.Results:Technical and successes were achieved in 90.5%(20/21)and there was no stent-related complication In the patients with right-sided OCRC.Technical and successes were 94.44%(68/72)and 93.01%(67/72)respectively,and the rate of stent-related complication were 9.72% In the patients with left-sided OCRC.In the patients with left-sided OCRC,the SEMS group had higher rates of primary resection(100%% VS 88.00%,P=0.001),primary resection with anastom-osis(88.89% VS 52.00%,P<0.001),stoma-free surgery(79.17% VS 50.00%,P=0.001),minimally invasive surgery(62.5% VS 36%,P=0.004),harvested lymph nodes(15VS 13,P=0.011),and had faster time to first flatus(3d VS 4d,P=0.011),and had less blood loss(50ml VS 100 ml,P=0.003)and postoperation morbidity(12.50%VS 28.00%,P=0.005)than the ES group.Howere the SEMS group of patients with right-sided OCRC had only a higher rate of minimally invasive surgery than the ES group of patients with right-sided OCRC.Conclusion:It is safe and feasible for self-expandable metallic stent as a bridge to surgery to treat right-and left-sided colorectal cancers with obstruction.The beneft of a SEMS as a bridge to surgery may be more for left-sided than for right-sided obstructions incolon cancer patients.