Takahara Hidenori, Fujisawa Akihiro, Kondo Yuhei, Akagami Masatoshi, Yokoyama Tadashi
Dept. of Surgery, Ako City Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):1980-1982.
We investigated the efficacy of colonic stent as a bridge to surgery(BTS)for malignant colonic obstruction retrospectively. 25 patients were inserted self-expandable metallic colonic stent as BTS(S group), 16 patients were placed trans-anal ileus tube as BTS(I group)and in 15 patients(E group)emergent surgery were performed. These 3 groups were investigated as follows. Technical success for colonic stent placement was obtained in all S group patients but clinical success rate was 92.0%(23/25). One was not decompressed sufficiently due to 2 obstructed colonic cancers and another patient stent was migrated. 3-year overall survival was 79.7%(S group), 75.0%(I group), 73.3%(E group), respectively. 3-year progression- free survival was 47.1%, 56.3%, 53.3%, respectively. Overall survival rate for S group patients was equivalent compared with patients of non-obstructive colonic cancer(control group)in stage Ⅱ/Ⅲ for the same investigation periods. Colonic stent for BTS was indicated to be safe and effective strategy for obstructive colon cancer, and further investigation are needed to confirm long-term outcomes.
我们回顾性研究了结肠支架作为恶性结肠梗阻手术桥梁（BTS）的疗效。25例患者置入自膨式金属结肠支架作为BTS（S组），16例患者置入经肛门肠梗阻导管作为BTS（I组），15例患者（E组）进行了急诊手术。对这3组进行了如下研究。S组所有患者均成功置入结肠支架，但临床成功率为92.0%（23/25）。1例因2处结肠癌梗阻减压不充分，另1例患者支架移位。3年总生存率分别为79.7%（S组）、75.0%（I组）、73.3%（E组）。3年无进展生存率分别为47.1%、56.3%、53.3%。在相同研究期间，S组患者的总生存率与Ⅱ/Ⅲ期非梗阻性结肠癌患者（对照组）相当。结肠支架作为BTS被认为是治疗梗阻性结肠癌的一种安全有效的策略，需要进一步研究以证实其长期疗效。
