Abstract
We report our hospital's treatment strategy for left-sided, obstructive colorectal cancer, which involves preoperative metallic stent placement followed by single-stage elective surgery. Subjects : A total of 49 patients was treated between July 2006 and October 2011. The subjects included 24 men and 25 women, with an age range of 51 to 86 years. Results : Stent placement was performed due to ileus in 41 patients and detection of severe stenosis on endoscopy in 6 patients. The placement site was the transverse colon (n=3), descending colon (n=9), sigmoid colon (n=27), or rectum (n=10). Stent placement was successful in 45 of 49 patients (91.8%). In three of the patients for whom stent placement was successful, emergency surgery was performed due to poor stent location (n=1), perforation following stent placement (n=1), or stent occlusion (n=1). Excluding these patients, stent placement was effective for 42 of the 49 patients (85.7%). Patients with successful stent placement were able to resume eating. In addition, the proximal end of the stenosed area was preoperatively located using an enema or endoscopy. The mean number of days to surgery was 11.7 days in cases of ileus and 8.5 days in cases of severe stenosis. The depth of cancer invasion was A/SS (n=26), SE (n=14), or S1 (n=9), while the stage of progression was stage II (n=17), IIIa or IIIb (n=13), or IV (n=19). Single-stage elective surgery was performed for 39 of the 42 patients for whom stent decompression was effective (92.9%). Conclusion : Metallic stent placement was associated with a favorable quality of life in patients following decompression or placement.
