Abstract
There is currently no established scoring method for colonic stricture and/or obstruction. The Colonic Stent Safe Procedure Research Group, a research group belonging to the Japan Gastroenterological Endoscopy Society, proposed a draft Colorectal Obstruction Scoring System (CROSS) . In this system, five scores were determined according to the following conditions : score 0 “Requiring continuous decompressive procedure” ; score 1 “No oral intake”, score 2 “Liquid or enteral nutrient”, score 3 “Soft solids, low-residue, and full diet with symptoms of stricture” and score 4 “Soft solids, low-residue, and full diet without symptoms of stricture”. To verify the feasibility of CROSS, we retrospectively evaluated 66 obstructive colorectal cancer cases treated with extendable metallic stent (EMS) as a bridge to surgery (BTS) . Clinical success rate─remission of obstruction─was 89.4% (59/66 cases) and clinical failure rate was 10.6% (7/66 cases) . In clinical success cases, the CROSS score improved in all cases when colorectal obstruction before and after stent placement was compared. In addition, the score improved from 0 to 4 in 90% of the success cases. On the other hand, 71% of the failure cases demonstrated no improvement of CROSS score when comparing before and after stent placement. We conclude that these results show CROSS is feasible to assess the BTS cases of EMS placement.
