title: Outcome of bridge to surgery stenting for obstructive left colon cancer.
abstract: BACKGROUND
  The aim of our study was to compare short- and long-term outcomes of stent insertion followed by surgery with those of emergency surgery for left colon malignant obstructions.
  
  
  METHODS
  The medical records of patients who received curative resection due to obstructive primary left colon cancer and who were diagnosed with stage II or III from January 2004 to December 2010 in six hospitals affiliated with The Catholic University of Korea were reviewed. One hundred and twelve patients in self-expandable metallic stent (SEMS) group were matched to 56 patients in the emergency surgery (ES) group using propensity score matching method. Overall survival (OS) and disease-free survival (DFS) were compared between the groups. Perioperative outcomes and pathologic results were also compared.
  
  
  RESULTS
  Baseline characteristics were comparable between the two groups after matching. The analysis of perioperative outcomes showed short-term advantages of stent insertion. Patients in the SEMS group were more likely (87.5 versus 75.0%, P = 0.049) to have a distal resection margin >5 cm. Harvesting ≥12 lymph nodes were more frequent (89.3 versus 71.4%, P = 0.007) in the SEMS group. Five-year DFS was 69.5% in the SEMS group and 73.1% in the ES group (P = 0.464). Five-year OS was not different between the groups (79.7 versus 77.7%, P = 0.989).
  
  
  CONCLUSIONS
  SEMS can be a reasonable therapeutic option for malignant obstruction in patients with left colon cancer until definitive conclusion about the long-term survival effect of SEMS is made from further large-scale prospective randomized trials.
authors.affiliation: Department of Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Min Ki
authors.initials: MK
authors.lastname: Kim
authors.affiliation: Department of Surgery, College of Medicine, St. Vincent Hospital, The Catholic University of Korea, Suwon, Republic of Korea.
authors.forename: Bong-Hyeon
authors.initials: BH
authors.lastname: Kye
authors.affiliation: Department of Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: In Kyu
authors.initials: IK
authors.lastname: Lee
authors.affiliation: Department of Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Seong Taek
authors.initials: ST
authors.lastname: Oh
authors.affiliation: Department of Surgery, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea.
authors.forename: Chang Hyeok
authors.initials: CH
authors.lastname: Ahn
authors.affiliation: Department of Surgery, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Republic of Korea.
authors.forename: Yoon Suk
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Surgery, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea.
authors.forename: Sang Chul
authors.initials: SC
authors.lastname: Lee
authors.affiliation: Department of Surgery, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Won-Kyung
authors.initials: WK
authors.lastname: Kang
mesh_terms: D000368:Aged; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents / Q000592:standards; D015607:Stents / Q000592:standards*; D016896:Treatment Outcome
keywords: colonic neoplasm; emergency; intestinal obstruction; stent; survival