In patients with bowel obstruction secondary to colorectal cancer (CRC), metal stents (MS) as a bridge to resection are associated with improved outcomes.
A study, published in the International Journal of Colorectal Diseases, used Hospital Episode Statistics (HES) to study a large cohort of subjects undergoing MS insertion followed by semi-elective curative resection in comparison with subjects undergoing immediate resection for bowel obstruction due to CRC.
Over a 10-year period, 4571 subjects were identified; 401 received MS and 4170 underwent surgery only. Median age was 71 years among MS subjects and 73 years in surgery-only subjects. Following propensity matching, 375 MS and 375 surgery-only subjects remained.
MS was associated with a lower rate of 30-day readmissions (7.5% vs 11.7%; P=0.047) and fewer respiratory complications (
Mortality was lower in the MS group at 30 days (1.9% vs 8.8%; P
The authors say the findings support “the hypothesis that bridging colorectal MS for subjects presenting with bowel obstruction are of benefit to patients, by potentially avoiding high-risk emergency surgery.”
They say prospective randomised studies should focus on the opportunities provided by MS to optimise subjects prior to eventual curative resection.