Background: Left colon cancer obstruction treatment is a debated topic in the literature. Stent placement is effective as a bridge-to-surgery strategy, but there are some concerns about the oncological safety for the reported higher risk of local and peritoneal recurrence. This study aims to compare the surgical and oncological outcomes of patients treated with stent followed by elective surgery with those treated with primary resection. Methods: This is a retrospective observational study. We included patients of both sexes, ≥18 years old, with a histological diagnosis of intestinal adenocarcinoma, and admitted to our hospital for left colon cancer obstruction demonstrated by CT scan without metastasis or perforation. They were treated through primary resection (PR) or stent placement followed by elective surgery (SR). The two groups were compared for general characteristics, surgical outcomes, and oncological outcomes (metastasis and local recurrence) at 30 days, 90 days, 1 year, and 3 years. Post-operative quality of life (QoL) was also investigated. Results: The SR group showed a shorter hospital stay, a lower post-operative mortality, a lower stoma rate at 1 year, and a higher number of minimally invasive procedures. Oncological outcomes were not different compared to the PR group. The SR group demonstrated better QoL in two out of six items on the EQ-5D-5L test. Conclusions: Stent placement as a bridge-to-surgery strategy is feasible and provides better surgical outcomes in terms of post-operative complications, surgical approach, stoma rate, and QoL. Oncological outcomes were not reported differently, but further studies should be conducted to better evaluate this aspect.
背景：左半结肠癌梗阻的治疗在文献中是一个备受争议的话题。支架置入作为手术过渡策略是有效的，但由于报道显示其局部和腹膜复发风险较高，其肿瘤学安全性存在一些担忧。本研究旨在比较支架置入后择期手术与一期切除治疗患者的围手术期及肿瘤学结局。 方法：这是一项回顾性观察研究。我们纳入了男女不限、年龄≥18岁、经组织学诊断为肠腺癌、因CT证实无转移或穿孔的左半结肠癌梗阻入院治疗的患者。患者接受一期切除术（PR）或支架置入后择期手术（SR）治疗。比较两组患者在30天、90天、1年和3年时的一般特征、围手术期结局及肿瘤学结局（转移和局部复发），并调查术后生活质量。 结果：SR组住院时间更短、术后死亡率更低、1年造口率更低，且微创手术比例更高。肿瘤学结局与PR组无显著差异。在EQ-5D-5L量表的六个项目中，SR组有两个项目显示出更好的生活质量。 结论：支架置入作为手术过渡策略是可行的，在术后并发症、手术方式、造口率和生活质量方面能提供更好的围手术期结局。肿瘤学结局未见显著差异，但需要进一步研究以更全面评估该方面。
肿瘤(癌症)患者之家