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Efficacy and Safety Analysis of Emergency Endoscopic Self-Expanding Metal Stent Placement Without Fluoroscopic Assistance for Right-Sided Colonic Cancer Obstruction

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Traditionally, surgical treatment is recommended for right-sided colonic cancer obstruction (RCCO); however, the literature comparing surgical or non-surgical procedures is lacking.

Methods

Patients included in this study were divided into two groups: one group received elective surgery after self-expanding metal stent (SEMS) placement, i.e., the bridge to surgery (BTS) group, and one group received emergency surgery (ES).

Results

Thirty-five patients were included in the BTS group and 60 patients underwent ES. The technical and clinical success rates for SEMS placement were 100% and 88.6%, respectively, while the short-term complication rates were 51.4% and 33.3% for the BTS and ES groups, respectively (p = 0.082). Overall, 2.9% and 3.3% of postoperative deaths occurred in the BTS and ES groups (p = 1.000). The 1-year overall survival (OS) rates were 91.4% and 88.3% (p = 0.840), 3-year OS rates were 85.7% and 81.7% (p = 0.860), and 5-year OS rates were 82.9% and 76.7% (p = 0.620) in the BTS and ES groups, respectively. No tumor recurrence was found in the BTS group but seven recurrences were found in the ES group (11.7%) [p = 0.091]. Laparoscopic surgery was chosen by 42.9% of patients in the BTS group and 26.7% of patients in the ES group (p = 0.104); however, the length of hospital stay (p = 0.001) was longer in the BTS group.

Conclusions

In the two groups, no differences were found in terms of postoperative complications and mortality as well as OS. The BTS group preferred to perform laparoscopic surgery and the technical success rate of stenting was high, therefore SEMS for RCCO was considered safe and feasible.

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Funding

This research did not receive any specific Grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Yunfeng Huang and Foqiang Liao contributed equally to this research.

Authors and Affiliations

  1. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China

    Yunfeng Huang MD, Foqiang Liao MD, Zhenyi Zhan MD & Xu Shu MD, PhD

  2. Department of Emergency@Trauma Center, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China

    Xiang Chen MD & Haiming Chen MD

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  1. Yunfeng Huang MD
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Contributions

YH collected data, analyzed the relevant information, and drafted the manuscript; FL guided the article revision; ZZ collected data; XC and HC clinically managed the patient; XS designed the article, approved the final submission, and clinically managed the patient.

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Correspondence to Haiming Chen MD or Xu Shu MD, PhD.

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Huang, Y., Liao, F., Zhan, Z. et al. Efficacy and Safety Analysis of Emergency Endoscopic Self-Expanding Metal Stent Placement Without Fluoroscopic Assistance for Right-Sided Colonic Cancer Obstruction. Ann Surg Oncol 31, 3212–3221 (2024). https://doi.org/10.1245/s10434-024-14909-6

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  • DOI: https://doi.org/10.1245/s10434-024-14909-6

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