title: Colorectal resection after stent insertion for obstructing cancer:  comparison between open and laparoscopic approaches.
abstract: OBJECTIVE
  To evaluate surgical outcomes after stent insertion for obstructing colorectal malignancy and to compare between laparoscopic and open approach.
  
  
  METHODS
  Surgical resection was performed after stent insertion for malignant colorectal obstruction in 36 patients with a median age of 73 years. Eighteen patients were treated with open resection, whereas 18 underwent a laparoscopic resection. The outcomes were evaluated and comparison was made between patients with laparoscopic and open resection.
  
  
  RESULTS
  The mean interval between stent insertion and surgery was 11 days. One patient died within 30 days (2.8%). The overall incidence of postoperative morbidity was 22% and reoperation was required in 3 patients (8.8%). The median postoperative hospital stay was 8.5 days for the open surgery group and 5.5 days for the laparoscopic group (P = 0.004). The postoperative morbidity rates for the open and laparoscopic groups were 33.3% and 11.1%, respectively (P = 0.228). In those patients with nonmetastatic disease, with the median follow-up of 20 months, the 5-year survival rate was 49.5%.
  
  
  CONCLUSIONS
  Our experience showed that after successful endoscopic stent insertion for malignant colorectal obstruction, elective surgical resection could be performed safely. The combined endoscopic and laparoscopic procedure provides a less invasive alternative to the multistage open operations and is feasible for patients with obstructing colon cancer.
authors: Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong. lawwl@hkucc.hku.hk
authors: Wai L
authors: WL
authors: Law
authors: Jensen T C
authors: JT
authors: Poon
authors: Joe K M
authors: JK
authors: Fan
authors: Oswens S H
authors: OS
authors: Lo
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005240:Feasibility Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D007902:Length of Stay; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011351:Proctoscopy / Q000379:methods*; D011446:Prospective Studies; D012086:Reoperation; D015607:Stents