Comparative study between colonic metallic stent and anal tube decompression for Japanese patients with left-sided malignant large bowel obstruction

被引：24

作者：

Kagami, Satoru ^{[1
]}

Funahashi, Kimihiko ^{[1
]}

Ushigome, Mitsunori ^{[1
]}

Koike, Junichi ^{[1
]}

Kaneko, Tomoaki ^{[1
]}

Koda, Takamaru ^{[1
]}

Kurihara, Akiharu ^{[1
]}

Nagashima, Yasuo ^{[1
]}

Yoshino, Yu ^{[1
]}

Goto, Mayu ^{[1
]}

Mikami, Tetsuo ^{[2
]}

Chino, Kumiko ^{[3
]}

机构：

[1] Toho Univ, Dept Gen & Gastroenterol Surg, Omori Med Ctr, Ota Ku, 6-11-1 Omorinishi, Tokyo 1438541, Japan

[2] Toho Univ, Dept Pathol, Sch Med, Ota Ku, 5-21-16 Omorinishi, Tokyo 1438540, Japan

[3] US Naval Hosp, Dept Internal Med, 1 Chome Tomari Cho, Yokosuka, Kanagawa 2380001, Japan

来源：

WORLD JOURNAL OF SURGICAL ONCOLOGY | 2018年 / 16卷

关键词：

Left-sided malignant large bowel obstruction; Colonic metallic stent; Trans-anal decompression tube; Short- and mid-term outcomes; TRANSANAL-DRAINAGE-TUBE; COLORECTAL OBSTRUCTION; EMERGENCY-SURGERY; PLACEMENT; EFFICACY; SAFETY; BRIDGE;

D O I：

10.1186/s12957-018-1509-0

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundSurgical management of malignant bowel obstruction carries with high morbidity and mortality. Placement of a trans-anal decompression tube (TDT) has traditionally been used for malignant bowel obstruction as a bridge to surgery. Recently, colonic metallic stent (CMS) as a bridge to surgery for malignant bowel obstruction, particularly left-sided malignant large bowel obstruction (LMLBO) caused by colorectal cancer, has been reported to be both a safe and feasible option. The aim of this retrospective study is to evaluate the clinical effects of CMS for LMLBO as a bridge to surgery compared to TDT.MethodsBetween January 2000 and December 2015, we retrospectively evaluated outcomes of 59 patients with LMLBO. We compared the outcomes of 26 patients with CMS for LMLBO between 2013 and 2015 (CMS group) with those of 33 patients managed with TDT between 2003 and 2011 (TDT group) by the historical study. LMLBO was defined as a large bowel obstruction due to a colorectal cancer that was diagnosed by computed tomography and required emergent decompression.ResultsAll patients in the CMS group were successfully decompressed (p=0.03) and could initiate oral intake after the procedure (p<0.01). Outcomes in the CMS group were superior to the TDT group in the following areas: duration of tube placement (p<0.01), surgical approach (p<0.01), operation time (p<0.01), number of resected lymph nodes (p<0.001), and rate of curative resection (p<0.01). However, no significant differences were found in the overall postoperative complication rate (p=0.151), surgical site infection rate (p=0.685), hospital length of stay (p=0.502), and the need for permanent ostomy (p=0.745). The 3-year overall survival rate of patients in the CMS and TDT groups was 73.0% and 80.9%, respectively, and this was not significant (p=0.423).ConclusionsTreatment with CMS for patients with LMLBO as a bridge to surgery is safe and demonstrated higher rates of resumption of solid food intake and temporary discharge prior to elective surgery compared to TDT. Oncological outcomes during mid-term were equivalent.

引用

页数：7

共 15 条

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