Aoki Ryosuke, Hondo Nao, Kitazawa Masato, Nakamura Satoshi, Koyama Makoto, Kataoka Masahiro, Tanaka Hirokazu, Iguchi Takuya, Park Yonghan, Soejima Yuji
Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Nagano, Japan.
Cancer Rep (Hoboken). 2025 Jun;8(6):e70255. doi: 10.1002/cnr2.70255.
Self-expandable metal stent (SEMS) placement for obstructive colorectal cancer (OCRC) is widely performed as a bridge to surgery because of its lower mortality rate than emergency surgery. However, the long-term outcomes remain unclear because of the risk of complications and cancer recurrence. This study investigated the short- and long-term outcomes of SEMS placement for OCRC.
We retrospectively reviewed the clinicopathological data of patients with OCRC who underwent preoperative treatment and tumor resection at our institution between April 2004 and March 2022. Among 113 patients with OCRC, 30 underwent SEMS placement (Group S) and 36 underwent ileus tube insertion (Group T); Group S had more older patients and fewer pT4 cases; no other characteristics differed. Incidence of severe complications was 0% versus 16.7% (p < 0.01); postoperative hospital stay was 14.3 versus 26.6 days (p < 0.01); medical costs were comparable between the groups. The long-term outcomes of Group S and patients with non-OCRC who underwent surgery during the same period were compared after propensity score matching. The 5-year survival rates were 69.5% and 77.1%; the 5-year recurrence-free survival rates were 44.5% and 55.5%, without significant difference.
In conclusion, SEMS placement was more effective than ileus tube placement in treating OCRC.
自膨式金属支架（SEMS）置入术用于治疗梗阻性结直肠癌（OCRC），由于其死亡率低于急诊手术，因此作为手术桥梁被广泛应用。然而，由于存在并发症和癌症复发风险，其长期疗效仍不明确。本研究调查了SEMS置入术治疗OCRC的短期和长期疗效。
我们回顾性分析了2004年4月至2022年3月期间在我院接受术前治疗和肿瘤切除的OCRC患者的临床病理资料。113例OCRC患者中，30例行SEMS置入术（S组），36例行肠梗阻导管置入术（T组）；S组老年患者更多，pT4病例更少；其他特征无差异。严重并发症发生率分别为0%和16.7%（p<0.01）；术后住院时间分别为14.3天和26.6天（p<0.01）；两组医疗费用相当。倾向评分匹配后，比较了S组与同期接受手术的非OCRC患者的长期疗效。5年生存率分别为69.5%和77.1%；5年无复发生存率分别为44.5%和55.5%，无显著差异。
总之，SEMS置入术在治疗OCRC方面比肠梗阻导管置入术更有效。
