Aim
This 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.
Method
Patients 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.
Results
Patients 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 12 days, P = 0.001). With a median follow‐up of 26.5 and 31.3 months for the stenting and surgical resection groups, there was no difference in overall and disease‐free survival (overall survival 30 vs 31 months, P = 0.858; disease‐free survival 13 vs 12 months, P = 0.989). There was no difference in the rate of systemic recurrence (8 vs 13, P = 0.991).
Conclusion
Stenting 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.