Long-term outcome of stenting as a bridge to surgery for acute left-sided malignant colonic obstruction

AimThis study aimed to evaluate both the short- and long-term outcomes associated with colonic stenting as a bridge to surgery in patients with obstructing adenocarcinoma of the colon. MethodPatients with potentially curable acute left-sided colonic obstruction treated with stenting as a bridge to surgery (n=28) or with emergency surgical resection (n=39) from January 1998 to December 2008 were identified from a prospectively maintained database. Short-term data on postoperative mortality, morbidity, necessity of intensive care and length of hospital stay were compared. Overall survival and disease-free survival were also analysed. ResultsPatients in the two study arms had similar demographic profiles. Those receiving preoperative stenting had a higher likelihood of a laparoscopic resection (P<0.001). The emergency surgery group had a higher rate of postoperative complications (P=0.024), rate of intensive care unit admission (P=0.013) and longer total length of hospital stay (9 vs 12days, P=0.001). With a median follow-up of 26.5 and 31.3months for the stenting and surgical resection groups, there was no difference in overall and disease-free survival (overall survival 30 vs 31months, P=0.858; disease-free survival 13 vs 12months, P=0.989). There was no difference in the rate of systemic recurrence (8 vs 13, P=0.991). ConclusionStenting as a bridge to surgery is a safe strategy for acute left-sided colonic obstruction with improved short-term outcome and comparable long-term oncological results.