Obstructive colon cancer is the cancer of the colon in which malignancy occludes the lumen of the colon. Decompressing stoma (DS) and self-expandable metal stent (SEMS) are two of the routinely used procedures as a bridge to elective surgery. This study aims to compare DS and SEMS as a bridge to surgery for nonlocally advanced obstructive colon cancer.
In this national, population-based cohort study, a total of 3,153 patients (mean age 69.7, 55.2% men) with left-sided obstructive colon cancer were included. Patients who underwent DS or SEMS were evaluated, and the primary outcomes of the study were primary anastomosis rate, complications, postresection presence of stoma, permanent stoma, additional interventions, disease-free survival, and overall survival.
Of 3,153 eligible patients, 443 underwent bridge to surgery (DS: 240, SEMS: 203). Further matching using propensity scores reduced 121 patients in each group. When compared with the SEMS group, patients who underwent DS had more primary anastomoses (86% vs. 75%), more postresection stomas (66.9% vs. 29.1%), more soma reversal (57.5% vs. 28.2%) but fewer major complications (5.8% vs. 15.3%). Three-year disease-free and overall survival rates in the DS group were 64.0% and 78%, as compared with 56.9% and 71.8% in the SEMS group.
The research concluded that DS as a bridge to surgery for patients with left-sided obstructive colon cancer had both upsides and downsides when compared with SEMS.