Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul;37(7):1316-1325.
doi: 10.1111/jgh.15857. Epub 2022 Apr 24.

Effectiveness of colonic stent placement for obstructive colorectal cancers: An analysis of short-term results using a nationwide database in Japan

Rintaro Moroi  1 , Kunio Tarasawa  2 , Yusuke Shimoyama  1 , Masatake Kuroha  1 , Hisashi Shiga  1 , Yoichi Kakuta  1 , Kiyohide Fushimi  3 , Kenji Fujimori  2 , Yoshitaka Kinouchi  1 , Atsushi Masamune  1
Affiliations

Effectiveness of colonic stent placement for obstructive colorectal cancers: An analysis of short-term results using a nationwide database in Japan

Rintaro Moroi et al. J Gastroenterol Hepatol. 2022 Jul.

Abstract

Background and aims: Self-expandable metallic stent (SEMS) is widely used for obstructive colorectal cancer (OCC). Both SEMS and urgent surgery have several merits and demerits. This study aimed to clarify the efficacy of SEMS by comparing the mortality rate after the hospitalization between SEMS and urgent surgery for OCC.

Methods: We collected OCC patients' data using the Diagnosis Procedure Combination (DPC) database system. We divided eligible patients into the SEMS and urgent surgery groups using propensity score matching and compared in-hospital death rates, length of hospitalization, and medical costs. We also conducted logistic regression analysis to identify clinical factors affecting in-hospital deaths.

Results: We enrolled 17 140 cases after propensity score matching. SEMS reduced the in-hospital death rate compared with urgent surgery (2.0% vs 3.6%, P < 0.0001). Length of hospitalization was shorter in the SEMS group than in the urgent surgery group (16 vs 25 days, P < 0.0001). Medical costs were lower in the SEMS group than in the urgent surgery group (1 663 550 vs 2 424 082 JPY, P < 0.0001). Multivariate analysis also showed that SEMS reduced in-hospital death (odds ratio = 0.58, 95% confidence interval: 0.50-0.70, P < 0.0001).

Conclusion: Self-expandable metallic stent placement for OCC might reduce the mortality rate in short term and shorten the length of hospitalization. These results facilitate considering SEMS with careful judgment for its indication when treating OCC patients.

Keywords: obstructive colorectal cancer; self-expandable metallic stent; urgent surgery.

PubMed Disclaimer

References

    1. Biondo S, Parés D, Frago R, Martí-Ragué J, Kreisler E, de Oca J, Jaurrieta E. Large bowel obstruction: predictive factors for postoperative mortality. Dis. Colon Rectum 2004; 47: 1889-1897. https://doi.org/10.1007/s10350-004-0688-7
    1. Ohman U. Decreased operative mortality in colorectal cancer but unchanged therapeutic results during 30-40 years. Lakartidningen 1982; 79: 1001-1004.
    1. Phillips RK, Hittinger R, Fry JS, Fielding LP. Malignant large bowel obstruction. Br. J. Surg. 1985; 72: 296-302. https://doi.org/10.1002/bjs.1800720417
    1. Carraro PG, Segala M, Cesana BM, Tiberio G. Obstructing colonic cancer: failure and survival patterns over a ten-year follow-up after one-stage curative surgery. Dis. Colon Rectum 2001; 44: 243-250. https://doi.org/10.1007/BF02234300
    1. Okuda Y, Shimura T, Yamada T, Hirata Y, Yamaguchi R, Sakamoto E, Kataoka H. Colorectal obstruction is a potential prognostic factor for stage II colorectal cancer. Int. J. Clin. Oncol. 2018; 23: 1101-1111. https://doi.org/10.1007/s10147-018-1307-2

LinkOut - more resources