Endoscopy 2019; 51(04): S216
DOI: 10.1055/s-0039-1681815
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Colon and rectum ePosters
Georg Thieme Verlag KG Stuttgart · New York

LONG-TERM SURVIVAL ANALYSIS AFTER ENDOSCOPIC STENTING AS A BRIDGE TO SURGERY FOR MALIGNANT COLONIC OBSTRUCTION: COMPARISON WITH EMERGENCY SURGERY

R Corsato Scomparin
1   Cancer Institute of São Paulo, Endoscopy, São Paulo, Brazil
,
B Costa Martins
2   Cancer Institute of São Paulo/University of São Paulo, Endoscopy, São Paulo, Brazil
,
CF Sparapan Marques
3   Cancer Institute of São Paulo, Surgery, São Paulo, Brazil
,
C Nahas
3   Cancer Institute of São Paulo, Surgery, São Paulo, Brazil
,
F Shiguehissa Kawaguti
1   Cancer Institute of São Paulo, Endoscopy, São Paulo, Brazil
,
L Lenz
1   Cancer Institute of São Paulo, Endoscopy, São Paulo, Brazil
,
A Safatle-Ribeiro
1   Cancer Institute of São Paulo, Endoscopy, São Paulo, Brazil
,
G Andrade de Paulo
1   Cancer Institute of São Paulo, Endoscopy, São Paulo, Brazil
,
U Ribeiro
3   Cancer Institute of São Paulo, Surgery, São Paulo, Brazil
,
S Nahas
3   Cancer Institute of São Paulo, Surgery, São Paulo, Brazil
,
F Maluf-Filho
1   Cancer Institute of São Paulo, Endoscopy, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Colorectal self-expanding metal stents (SEMS) can be used as a bridge therapy in acute malignant colorectal obstruction for elective surgical treatment in better clinical conditions. There are reports of higher rates of tumor recurrence in the long-term and worse survival in the SEMS group. The aim of this study was to compare the long-term results of colorectal SEMS versus emergency surgery in patients with malignant colorectal obstruction with curative purposes. The main outcome was overall survival rate.

Methods:

This is a retrospective comparison of patients who underwent placement of colorectal SEMS as a bridge therapy for malignant colorectal obstruction versus patients submitted to emergency surgery for the same clinical condition, with curative intentions in both groups. Inclusion: Patients with resectable colorectal neoplasia with obstructive signs and symptoms submitted to emergency surgery or SEMS. Exclusion: evidence of unresectable disease and/or metastatic disease.

Results:

406 eligible patients. Groups are similar in age, gender, staging and ECOG status. SEMS group: 55 eligible patients of whom 34 were excluded (palliative care) and 21 were included. There were 3 perforations, 1 silent perforation, 3 reobstructions and 3 bleedings. There were 12 minor complications (9 pain, 2 tenesmus and 1 incontinence). Mean follow-up time was 16 months, (range 1 – 67). Surgery group: 351 eligible of whom 284 were excluded (evidence of unresectable disease) and 67 were included. Mean follow-up time was 17.6 months (range 5 – 69). Analysis of SEMS versus Surgery: primary anastomosis 70% vs. 14.4% (p < 0.0001); temporary ostomy 35% vs. 71.6% (p = 0.0015); permanent ostomy 15% vs. 35% (p = 0.1); fistula 5% vs. 14.9% (p = 0.44); local recurrence 38.1% vs. 22.4% (p = 0.14). There was no difference in the overall survival rate (Log rank p = 0.873).

Conclusions:

SEMS group showed better rates of primary anastomoses and permanent ostomy. There was no difference in local recurrence and overall survival rate between the groups.