title: Clinical benefits and oncologic equivalence of self-expandable metallic stent insertion for right-sided malignant colonic obstruction.
abstract: The efficacy of stenting for right-sided malignant colonic obstruction is unknown. This study aimed to evaluate the safety, feasibility, and clinical benefits of self-expandable metallic stent insertion for right-sided malignant colonic obstruction.
  
  
  
  Clinical data from patients who underwent right hemicolectomy for right colon cancer from January 2006 to July 2014 at three Korea University hospitals were retrospectively reviewed. A total of 39 patients who developed malignant obstruction in the right-sided colon were identified, and their data were analyzed.
  
  
  
  Stent insertion was attempted in 16 patients, and initial technical success was achieved in 14 patients (87.5 %). No stent-related immediate complications were reported. Complete relief from obstruction was achieved in all 14 patients. Twenty-five patients, including two patients who failed stenting, underwent emergency surgery. In the stent group, 93 % (13/14) of patients underwent elective laparoscopic surgery, and only one surgery was converted to an open procedure. All patients in the emergency group underwent emergency surgery within 24 h of admission. In the emergency group, only 12 % (3/25) of patients underwent laparoscopic surgery, with one surgery converted to an open procedure. All patients in both groups underwent either laparoscopy-assisted or open right/extended right hemicolectomy with primary anastomoses as the first operation. The operative times, retrieved lymph nodes, and pathologic stage did not differ between the two groups. Postoperative hospital stay (9.4 ± 3.4 days in the stent group vs. 12.4 ± 5.9 in the emergency group, p = 0.089) and time to resume oral food intake (3.2 ± 2.1 days in the stent group vs. 5.7 ± 3.4 in the emergency group, p = 0.019) were shorter in the stent group. And there were no significant differences in disease-free survival and overall survival between the two groups.
  
  
  
  Stent insertion appears to be safe and feasible in patients with right-sided colonic malignant obstruction. It facilitates minimally invasive surgery and may result in better short-term surgical outcomes.
authors.affiliation: Department of Surgery, Korea University Ansan Hospital, Ansan, Republic of Korea.
authors.forename: Woong Bae
authors.initials: WB
authors.lastname: Ji
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 126-1, Anam-dong 5-ga, Seongbuk-gu, Seoul, 136-705, Republic of Korea. kjm64819@naver.com.
authors.forename: Jung Myun
authors.initials: JM
authors.lastname: Kwak
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 126-1, Anam-dong 5-ga, Seongbuk-gu, Seoul, 136-705, Republic of Korea.
authors.forename: Dong Woo
authors.initials: DW
authors.lastname: Kang
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 126-1, Anam-dong 5-ga, Seongbuk-gu, Seoul, 136-705, Republic of Korea.
authors.forename: Han Deok
authors.initials: HD
authors.lastname: Kwak
authors.affiliation: Department of Surgery, Korea University Ansan Hospital, Ansan, Republic of Korea.
authors.forename: Jun Won
authors.initials: JW
authors.lastname: Um
authors.affiliation: Department of Surgery, Korea University Guro Hospital, Seoul, Republic of Korea.
authors.forename: Sun-Il
authors.initials: SI
authors.lastname: Lee
authors.affiliation: Department of Surgery, Korea University Guro Hospital, Seoul, Republic of Korea.
authors.forename: Byung-Wook
authors.initials: BW
authors.lastname: Min
authors.affiliation: Department of Surgery, Konyang University Hospital, Daejeon, Republic of Korea.
authors.forename: Nak Song
authors.initials: NS
authors.lastname: Sung
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 126-1, Anam-dong 5-ga, Seongbuk-gu, Seoul, 136-705, Republic of Korea.
authors.forename: Jin
authors.initials: J
authors.lastname: Kim
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 126-1, Anam-dong 5-ga, Seongbuk-gu, Seoul, 136-705, Republic of Korea.
authors.forename: Seon Hahn
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D003082:Colectomy; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents
keywords: Obstruction; Right colon cancer; Self-expandable metallic stent