Outcomes of Patients with Left-Sided Obstructive Colorectal Cancer: Comparison between Self-Expandable Metallic Stent and Other Treatment Methods

The aim of this multi-institutional retrospective study was to evaluate the efficacy of preoperative self-expandable metallic stent (SEMS) placement for patients with left-sided obstructive colorectal cancer (OCRC).A total of 520 consecutive patients who received treatment for OCRC were enrolled. Of these patients, the data of 253 patients who underwent primary tumour resection for left-sided OCRC were reviewed. The short- and long-term outcomes were compared between the SEMS group and other three groups: transanal decompressive tube (TaDT), decompressive stoma (DS), and emergency resection (ER).The SEMS group had a higher frequency of laparoscopic surgery (P <0.001), lesser frequency of postoperative stoma (P <0.001), and more dissected lymph nodes (P <0.001) than that of other groups. Moreover, the SEMS group had shorter postoperative hospital stays than that of TaDT and ER groups (P = 0.005 and P <0.001, respectively). The Kaplan-Meier survival curves of recurrence-free survival and overall survival did not differ significantly between the SEMS group and the other three groups in patients with stage II and III diseases.Elective surgery after SEMS placement may improve short-term outcomes compared to other treatment strategies, with similar long-term outcomes.