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Nobuhisa Matsuhashi
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5993-9571
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Purpose Malignant large-bowel obstruction (MLBO) is a highly urgent condition in colorectal cancer with high complication rates. Self-expandable metal stent (SEMS) placement in MLBO is a new decompression treatment in Japan. Preoperative stent placement (bridge to surgery: BTS) avoids emergency surgery, but oncological influences of stent placement and post-BTS surgical approach remain unclear. We examined short- and long-term results of surgery for MLBO after SEMS placement in our hospital.
Methods We retrospectively reviewed 75 patients with MLBO who underwent resection after SEMS placement at our hospital from June 2013 to December 2018. Postoperative morbidity and mortality were evaluated by comparison with the surgical approach.
Results Tumor location was significantly higher in the left-side colon and rectum (n=59, 78.7%) than right-side colon (n=16, 21.3%). Technical and clinical success rates for SEMS placement were 97.3% and 96.0%, respectively. Laparoscopic surgery was performed in 54 patients (69.0%), and one-stage anastomosis was performed in 73 (97.3%). Postoperative complications were similar in the open surgery (Open) group (n=5, 23.8%) and laparoscopic surgery (Lap) group (n=7, 13.0%), with no severe complications requiring reoperation. Three-year overall survival (OS) and relapse-free survival (RFS) rates were not significantly different in the Lap vs Open group (67.5% vs 66.4%; 82.2% vs 62.5%).
Conclusion Preoperative stent treatment avoids stoma construction but allows anastomosis. One-time surgery was performed safely contributing to minimally invasive treatment and acceptable short- and long-term results.
Keywords
Malignant large-bowel obstruction, Self-expandable metal stent placement, Bridge to surgery, Postoperative complication
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
- Table.5.pdf
Table 5 Strategy for MLBO in our institute
- Supplementaltablereviced.docx
Details of each postoperative complication cases withmore than Clavien-Dindo grade IIIa.
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CURRENT STATUS: Published
View the published article at World Journal of Surgical Oncology.
Version 3
Posted 22 Sep, 2020
No community comments so far
Editorial decision: Accept
On 26 Sep, 2020
Editor assigned
On 21 Sep, 2020
Submission checks complete
On 20 Sep, 2020
Editor invited
On 20 Sep, 2020
No comments provided
Editorial decision: Major Revision
On 14 Sep, 2020
Review #1 received
Received 13 Sep, 2020
Review #3 received
Received 11 Sep, 2020
Review #2 received
Received 10 Sep, 2020
Reviewer #2 agreed
On 06 Sep, 2020
Reviewer #3 agreed
On 06 Sep, 2020
Reviewers invited
Invitations sent on 05 Sep, 2020
Reviewer #1 agreed
On 05 Sep, 2020
Editor assigned
On 04 Sep, 2020
Submission checks complete
On 03 Sep, 2020
Editor invited
On 03 Sep, 2020
No comments provided
Editorial decision: Major Revision
On 17 Aug, 2020
Review #5 received
Received 16 Aug, 2020
Review #4 received
Received 12 Aug, 2020
Review #2 received
Received 11 Aug, 2020
Review #3 received
Received 11 Aug, 2020
Reviewer #5 agreed
On 01 Aug, 2020
Reviewer #3 agreed
On 29 Jul, 2020
Reviewer #4 agreed
On 29 Jul, 2020
Reviewer #2 agreed
On 23 Jul, 2020
Review #1 received
Received 22 Jul, 2020
Reviewer #1 agreed
On 09 Jul, 2020
Editor assigned
On 06 Jul, 2020
Reviewers invited
Invitations sent on 06 Jul, 2020
Submission checks complete
On 05 Jul, 2020
Editor invited
On 05 Jul, 2020
First submitted
On 28 Jun, 2020
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at World Journal of Surgical Oncology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Nobuhisa Matsuhashi
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5993-9571
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at World Journal of Surgical Oncology.
Version 3
Posted 22 Sep, 2020
No community comments so far
Editorial decision: Accept
On 26 Sep, 2020
Editor assigned
On 21 Sep, 2020
Submission checks complete
On 20 Sep, 2020
Editor invited
On 20 Sep, 2020
No comments provided
Editorial decision: Major Revision
On 14 Sep, 2020
Review #1 received
Received 13 Sep, 2020
Review #3 received
Received 11 Sep, 2020
Review #2 received
Received 10 Sep, 2020
Reviewer #2 agreed
On 06 Sep, 2020
Reviewer #3 agreed
On 06 Sep, 2020
Reviewers invited
Invitations sent on 05 Sep, 2020
Reviewer #1 agreed
On 05 Sep, 2020
Editor assigned
On 04 Sep, 2020
Submission checks complete
On 03 Sep, 2020
Editor invited
On 03 Sep, 2020
No comments provided
Editorial decision: Major Revision
On 17 Aug, 2020
Review #5 received
Received 16 Aug, 2020
Review #4 received
Received 12 Aug, 2020
Review #2 received
Received 11 Aug, 2020
Review #3 received
Received 11 Aug, 2020
Reviewer #5 agreed
On 01 Aug, 2020
Reviewer #3 agreed
On 29 Jul, 2020
Reviewer #4 agreed
On 29 Jul, 2020
Reviewer #2 agreed
On 23 Jul, 2020
Review #1 received
Received 22 Jul, 2020
Reviewer #1 agreed
On 09 Jul, 2020
Editor assigned
On 06 Jul, 2020
Reviewers invited
Invitations sent on 06 Jul, 2020
Submission checks complete
On 05 Jul, 2020
Editor invited
On 05 Jul, 2020
First submitted
On 28 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at World Journal of Surgical Oncology.
Purpose Malignant large-bowel obstruction (MLBO) is a highly urgent condition in colorectal cancer with high complication rates. Self-expandable metal stent (SEMS) placement in MLBO is a new decompression treatment in Japan. Preoperative stent placement (bridge to surgery: BTS) avoids emergency surgery, but oncological influences of stent placement and post-BTS surgical approach remain unclear. We examined short- and long-term results of surgery for MLBO after SEMS placement in our hospital.
Methods We retrospectively reviewed 75 patients with MLBO who underwent resection after SEMS placement at our hospital from June 2013 to December 2018. Postoperative morbidity and mortality were evaluated by comparison with the surgical approach.
Results Tumor location was significantly higher in the left-side colon and rectum (n=59, 78.7%) than right-side colon (n=16, 21.3%). Technical and clinical success rates for SEMS placement were 97.3% and 96.0%, respectively. Laparoscopic surgery was performed in 54 patients (69.0%), and one-stage anastomosis was performed in 73 (97.3%). Postoperative complications were similar in the open surgery (Open) group (n=5, 23.8%) and laparoscopic surgery (Lap) group (n=7, 13.0%), with no severe complications requiring reoperation. Three-year overall survival (OS) and relapse-free survival (RFS) rates were not significantly different in the Lap vs Open group (67.5% vs 66.4%; 82.2% vs 62.5%).
Conclusion Preoperative stent treatment avoids stoma construction but allows anastomosis. One-time surgery was performed safely contributing to minimally invasive treatment and acceptable short- and long-term results.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
- Table.5.pdf
Table 5 Strategy for MLBO in our institute
- Supplementaltablereviced.docx
Details of each postoperative complication cases withmore than Clavien-Dindo grade IIIa.
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