Yinghao Cao1, Shenghe Deng1, Ke Wu1, Hai Zheng2, Ping Cheng2, Jingxiang Zhang2, Libo Chen2, Shouyuan Tang3, Pingfa Wang4, Xiaofeng Liao5, Yongkang Zhang5, Gaobo Zhu6, Qiaoyun Tong7, Jiliang Wang1, Jinbo Gao1, Xiaoming Shuai1, KaiXiong Tao1, Guobin Wang1, Jiang Li1, Kailin Cai8. 1. Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. 2. Department of Emergency and Trauma Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. 3. Department of General Surgery, Huangshi Central Hospital, Huangshi, 435000, Hubei Province, China. 4. Department of Digestive Disease, Huangshi Central Hospital, Huangshi, 435000, Hubei Province, China. 5. Department of General Surgery, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441021, Hubei Province, China. 6. Department of Emergency and Trauma Surgery, Yichang Central People's Hospital, China Three Gorges University, Yichang, 443003, Hubei Province, China. 7. Department of Digestive Disease, Yichang Central People's Hospital, China Three Gorges University, Yichang, 443003, Hubei Province, China. 8. Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. caikailin@hust.edu.cn.
Abstract
PURPOSE: Colonic perforation is a life-threatening complication after colonic stent insertion as a bridge to surgery for acute obstruction caused by colorectal cancer. The oncological consequence of colonic perforation after emergent surgical intervention was unknown. The aim of this short communication was to investigate whether or not the perforation and emergent surgery had obviously impact on the peritoneal recurrence and long-term survival of patients. METHODS: Data of the patients who underwent colorectal stenting as a bridge to surgery in 5 years from 2012 to 2017 was collected by the Endoscopical Surgery Group of Hubei. The perforated cases treated by emergent operation were retrospectively analyzed. RESULTS: During 5 years from 2012 to 2017, 116 cases of colorectal stenting as a bridge to surgery had been performed, and 7 patients had perforation after stent placement and treated by emergent surgery, including 1 case of synchronic liver metastasis treated by one-stage metastasectomy. One of the 7 patients died of septic shock after operation, and the remaining patients were followed up for 6-60 months. There was no evidence of abdominal implantation or extra-abdominal metastasis. CONCLUSION: This small case series implicated that colonic perforation after stent insertion for malignant colorectal obstruction treated by emergent surgery might not obviously increase the peritoneal implantation and metastasis.
PURPOSE:Colonic perforation is a life-threatening complication after colonic stent insertion as a bridge to surgery for acute obstruction caused by colorectal cancer. The oncological consequence of colonic perforation after emergent surgical intervention was unknown. The aim of this short communication was to investigate whether or not the perforation and emergent surgery had obviously impact on the peritoneal recurrence and long-term survival of patients. METHODS: Data of the patients who underwent colorectal stenting as a bridge to surgery in 5 years from 2012 to 2017 was collected by the Endoscopical Surgery Group of Hubei. The perforated cases treated by emergent operation were retrospectively analyzed. RESULTS: During 5 years from 2012 to 2017, 116 cases of colorectal stenting as a bridge to surgery had been performed, and 7 patients had perforation after stent placement and treated by emergent surgery, including 1 case of synchronic liver metastasis treated by one-stage metastasectomy. One of the 7 patients died of septic shock after operation, and the remaining patients were followed up for 6-60 months. There was no evidence of abdominal implantation or extra-abdominal metastasis. CONCLUSION: This small case series implicated that colonic perforation after stent insertion for malignant colorectal obstruction treated by emergent surgery might not obviously increase the peritoneal implantation and metastasis.
Entities:
Keywords:
Bridge to surgery; Colon cancer; Intestinal perforation; Metastasis; Self-expanding metal stent