Long-term outcomes of palliative colonic stenting versus emergency surgery for acute proximal malignant colonic obstruction: a multicenter trial

摘要

Background and study aims?Long-term data are limited regarding clinical outcomes of self-expanding metal stents as an alternative for surgery in the treatment of acute proximal MBO. The aim of this study was to compare the long-term outcomes of stenting to surgery for palliation in patients with incurable obstructive CRC for lesions proximal to the splenic flexure. Patients and methods?Retrospective multicenter cohort study of obstructing proximal CRC patients with who underwent insertion of a SEMS (n?=?69) or surgery (n?=?36) from 1999 to 2014. The primary endpoint was relief of obstruction. Secondary endpoints included technical success, duration of hospital stay, early and late adverse events (AEs) and survival. Results?Technical success was achieved in 62/69 (89.8?%) patients in the SEMS group and in 36?/36 (100?%) patients who underwent surgery (P?=?0.09). In the SEMS group, 10 patients underwent stenting as a bridge to surgery and 59 underwent stent placement for palliation. Clinical relief was achieved in 78?% of patients with stenting and in 100?% of patients who underwent surgery (P?