PMID- 33206763
OWN - NLM
STAT- MEDLINE
DCOM- 20201231
LR  - 20220629
IS  - 1980-5322 (Electronic)
IS  - 1807-5932 (Print)
IS  - 1807-5932 (Linking)
VI  - 75
DP  - 2020
TI  - Long-term survival analysis after endoscopic stenting as a bridge to surgery for 
      malignant colorectal obstruction: comparison with emergency diverting colostomy.
PG  - e2046
LID - 10.6061/clinics/2020/e2046 [doi]
LID - e2046
AB  - OBJECTIVE: The use of colorectal self-expanding metal stents (SEMS) as bridge 
      therapy for malignant colorectal obstruction was first reported more than 20 
      years ago. However, its use remains controversial. In this study, we aimed to 
      compare the long-term survival of patients with potentially resectable malignant 
      colorectal obstruction who had undergone colorectal SEMS placement and emergency 
      surgery. METHODS: This study was a retrospective analyses. Patients who received 
      treatment between 2009 and 2017 were included. According to the eligibility 
      criteria, 21 patients were included in the SEMS group and 67 patients were 
      included in the surgical group.. RESULTS: The majority of the patients in the 
      SEMS group were female (57.1%), whereas the majority of those in the surgical 
      group were male (53.7%). The median follow-up time was 60 months for both groups 
      with the same interquartile range of 60 months. There was no difference in the 
      overall survival rate (log rank p=0.873) and disease-free survival rate (log rank 
      p=0.2821) in the five-year analysis. There was no difference in local recurrence 
      rates (38.1% vs. 22.4%, p=0.14) or distant recurrence rates (33.3% vs. 50.7%, 
      p=0.16) in the SEMS and the surgical groups. Technical and clinical success rates 
      of endoscopic stenting were 95.3% and 85.7%, respectively. There were no 
      immediate adverse events (AEs). Severe AEs included perforation (14.3%), silent 
      perforation (4.7%), reobstruction (14.3%), and bleeding (14.3%). Mild AEs 
      included pain (42.8%), tenesmus (9.5%), and incontinence (4.76%). The limitations 
      of this study was retrospective and was conducted at a single center. 
      CONCLUSIONS: No differences in disease-free and overall survival rates were 
      observed in the five-year analysis of patients with resectable colorectal cancer 
      who had undergone SEMS placement or colostomy for the treatment of malignant 
      colorectal obstruction. Patients in the SEMS group had a higher rate of primary 
      anastomosis and a lower rate of temporary colostomy than did those in the surgery 
      group.
FAU - Scomparin, Rodrigo Corsato
AU  - Scomparin RC
AUID- ORCID: 0000-0003-0779-0562
AD  - Divisao de Endoscopia, Instituto do Cancer do Estado de Sao Paulo (ICESP), 
      Universidade de Sao Paulo, SP, BR.
FAU - Martins, Bruno Costa
AU  - Martins BC
AUID- ORCID: 0000-0002-0282-0753
AD  - Divisao de Endoscopia, Instituto do Cancer do Estado de Sao Paulo (ICESP), 
      Universidade de Sao Paulo, SP, BR.
FAU - Lenz, Luciano
AU  - Lenz L
AUID- ORCID: 0000-0002-7945-8158
AD  - Divisao de Endoscopia, Instituto do Cancer do Estado de Sao Paulo (ICESP), 
      Universidade de Sao Paulo, SP, BR.
FAU - Bento, Luiza Haendchen
AU  - Bento LH
AUID- ORCID: 0000-0003-2328-212X
AD  - Divisao de Endoscopia, Instituto do Cancer do Estado de Sao Paulo (ICESP), 
      Universidade de Sao Paulo, SP, BR.
FAU - Marques, Carlos Sparapam
AU  - Marques CS
AUID- ORCID: 0000-0003-4293-6301
AD  - Divisao de Endoscopia, Instituto do Cancer do Estado de Sao Paulo (ICESP), 
      Universidade de Sao Paulo, SP, BR.
FAU - Safatle-Ribeiro, Adriana
AU  - Safatle-Ribeiro A
AUID- ORCID: 0000-0001-7686-8859
AD  - Divisao de Endoscopia, Instituto do Cancer do Estado de Sao Paulo (ICESP), 
      Universidade de Sao Paulo, SP, BR.
FAU - Ribeiro, Ulysses Jr
AU  - Ribeiro U Jr
AUID- ORCID: 0000-0003-1711-7347
AD  - Divisao de Cirurgia, Instituto do Cancer do Estado de Sao Paulo (ICESP), 
      Universidade de Sao Paulo, SP, BR.
FAU - Nahas, Sergio Carlos
AU  - Nahas SC
AUID- ORCID: 0000-0002-2268-4146
AD  - Divisao de Cirurgia, Instituto do Cancer do Estado de Sao Paulo (ICESP), 
      Universidade de Sao Paulo, SP, BR.
FAU - Maluf-Filho, Fauze
AU  - Maluf-Filho F
AUID- ORCID: 0000-0001-8875-420X
AD  - Divisao de Endoscopia, Instituto do Cancer do Estado de Sao Paulo (ICESP), 
      Universidade de Sao Paulo, SP, BR.
LA  - eng
PT  - Journal Article
DEP - 20201111
PL  - United States
TA  - Clinics (Sao Paulo)
JT  - Clinics (Sao Paulo, Brazil)
JID - 101244734
SB  - IM
MH  - *Colorectal Neoplasms/complications/surgery
MH  - Colostomy
MH  - Female
MH  - Humans
MH  - *Intestinal Obstruction/etiology/surgery
MH  - Male
MH  - Neoplasm Recurrence, Local
MH  - Retrospective Studies
MH  - Stents
MH  - Treatment Outcome
PMC - PMC7603286
COIS- No potential conflict of interest was reported.
EDAT- 2020/11/19 06:00
MHDA- 2021/01/01 06:00
PMCR- 2020/01/01
CRDT- 2020/11/18 17:10
PHST- 2020/05/19 00:00 [received]
PHST- 2020/09/04 00:00 [accepted]
PHST- 2020/11/18 17:10 [entrez]
PHST- 2020/11/19 06:00 [pubmed]
PHST- 2021/01/01 06:00 [medline]
PHST- 2020/01/01 00:00 [pmc-release]
AID - S1807-5932(22)00409-4 [pii]
AID - cln_75p1 [pii]
AID - 10.6061/clinics/2020/e2046 [doi]
PST - epublish
SO  - Clinics (Sao Paulo). 2020 Nov 11;75:e2046. doi: 10.6061/clinics/2020/e2046. 
      eCollection 2020.