Premium
Feasibility of laparoscopic surgery after stent insertion for obstructive colorectal cancer
Author(s) -
Shimizu Hideharu,
Yamazaki Ryoto,
Ohtsuka Hideo,
Osaka Itaru,
Takuma Kunio,
Morita Yasuhiro
Publication year - 2018
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12434
Subject(s) - medicine , colorectal cancer , laparoscopy , surgery , laparoscopic surgery , stent , ileus , stoma (medicine) , cancer
A growing number of patients with obstructive colorectal cancer are being treated with self‐expanding metallic stents (SEMS) followed by laparoscopic resection. The aim of this study was to assess the feasibility of stent insertion and laparoscopic surgery for obstructive colorectal cancer and to compare these outcomes to regular laparoscopic surgery for non‐obstructive colorectal cancer. Methods We retrospectively analyzed the outcomes of patients with a malignant colonic obstruction who underwent SEMS placement followed by elective laparoscopic resection. The comparison was made between stent‐laparoscopy and laparoscopy alone for non‐obstructive colorectal cancer. Results Colonic stenting as a bridge to surgery was successful in 97.1% of all cases. Fifteen patients underwent an elective laparoscopic surgery for left‐sided colon and rectal cancer after SEMS. The mean interval from SEMS insertion to laparoscopic surgery was 21.5 days. There was no conversion to open surgery and no need for a diverting stoma. One patient (6.7%) experienced paralytic ileus. Our comparison of stent‐laparoscopy to regular laparoscopy for non‐obstructive colorectal cancer treatment showed comparable short‐term postoperative outcomes with the exception of blood loss, which was greater in the stent‐laparoscopy group. Conclusion Elective laparoscopic surgery after colonic stenting is a safe and feasible strategy for the treatment of an acute malignant colonic obstruction.