Long-Term Survival Analysis After Endoscopic Stenting as a Bridge to Surgery for Malignant Colorectal Obstruction: Comparison With Emergency Diverting Colostomy

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Aims More than 20 years have elapsed since the first description of the use of Colorectal self-expanding metal stents (SEMS) as bridge therapy of malignant colorectal obstruction, and the theme remains controversial. The aim of this study was to compare the long-term survival of patients with malignant colorectal obstruction with potentially resectable disease who underwent colorectal SEMS versus emergency surgery. Methods Retrospective analyses. Patients included from 2009 to 2017. According to the eligibility criteria, 21 patients included in the SEMS group and 67 were included in the surgical arm. Results The majority in the SEMS group were female (57.1 %). In the surgery group, the majority were male (53.7 %). Main outcome The median follow-up time was 60mo for both groups with the same 75 % interquartile range of 60mo. 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 five-year analysis. Secondary outcome There was no difference in local recurrence (38.1 % vs 22.4 %, p=0.14) or distant recurrence rates (33.3 % vs 50.7 %, p=0.16) in the SEMS vs. the surgical groups, respectively. Technical and clinical success rates of endoscopic stenting were 95.3 and 85.7 %, respectively. There were no immediate adverse events (AE). Severe AEs were perforation (14.3 %), silent perforation 4.7 %, reobstruction 14.3 % and bleeding 14.3 %. Mild AE were pain 42.8 %, tenesmus 9.5 % and incontinence 4.76 %. Limitations Retrospective and single-centered study. Conclusions Our study did not find differences in disease-free survival and overall survival in 5-year analysis in patients with resectable colorectal cancer submitted to SEMS versus colostomy for the treatment of malignant colorectal obstruction. SEMS group had a higher rate of primary anastomosis and a lower rate of temporary colostomy. Citation: Corsato Scomparin R , Costa Martins B, Lenz L et al. eP244 LONG-TERM SURVIVAL ANALYSIS AFTER ENDOSCOPIC STENTING AS A BRIDGE TO SURGERY FOR MALIGNANT COLORECTAL OBSTRUCTION: COMPARISON WITH EMERGENCY DIVERTING COLOSTOMY. Endoscopy 2021; 53: S178. Publication History Publication Date: 19 March 2021 (online) © 2021. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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