Benefits of using a self-expandable metallic stent as a bridge to surgery for right- and left-sided obstructive colorectal cancers.

Purpose: To assess the benefit of placing a self-expandable metallic stent (SEMS) as a bridge to surgery for obstructive colorectal cancer (OCRC) according to the tumor site.

Methods: The subjects of this retrospective multicenter cohort study were 201 patients with OCRC, but without initial bowel perforation, who were treated either with a self-expandable metallic stent (SEMS) as a bridge to surgery (n = 109) or with primary surgery (PS; n = 92) between 2014 and 2016. The cohort consisted of 68 patients with right-sided and 133 left-sided OCRC. We evaluated the short-term surgical outcomes for each side.

Results: The SEMS group of patients with left-sided OCRC had significantly higher rates of primary resection, primary resection with anastomosis, stoma-free surgery, and laparoscopic surgery than the PS group of patients with left-sided OCRC. In contrast, the SEMS group of patients with right-sided OCRC had only a significantly higher rate of laparoscopic surgery than the PS group of patients with right-sided OCRC, but they had a longer overall hospital stay. There were no significant differences between the two treatment groups in the rates of morbidity or mortality, for either right-sided or left-sided OCRC.

Conclusion: The benefit of a SEMS as a bridge to surgery may be less for right-sided than for left-sided obstructions in colon cancer patients.