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Higher rate of perineural invasion in stent–laparoscopic approach in comparison to emergent open resection for obstructing left-sided colon cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

We compared oncologic outcomes of laparoscopic surgery following self-expandable metallic stent (SEMS) insertion with one-stage emergency surgical treatment of obstructive left-sided colon and rectal cancers.

Methods

From April 1996 to October 2007, 95 consecutive patients with left-sided obstructive colorectal cancers were included: 25 underwent preoperative stenting and elective laparoscopic surgery (SLAP) and 70 underwent emergency open surgery with intraoperative colon lavage (OLAV). Long-term oncologic outcomes were analyzed on an intention-to-treat basis.

Results

There were no significant differences in baseline characteristics of patients between groups. Perineural invasion of the primary tumor was more frequent with SLAP (76 vs. 51.4 %, p = 0.033). The median follow-up was 51 months (range, 4–139 months). There were no significant differences between groups in 5-year overall survival rates (SLAP vs. OLAV, 67.2 vs. 61.6 %, p = 0.385). Five-year disease-free survival rates were also similar between groups (SLAP vs. OLAV, 61.2 vs. 60.0 %, p = 0.932).

Conclusions

Laparoscopic surgery after SEMS was feasible and safe for patients with obstructive left-sided colorectal cancer, and oncologic outcomes were comparable to emergency open surgery with intraoperative colon lavage. These results support the continued use of SLAP in this setting. Further large-scale study is needed to investigate any clinical impact attached to the higher rates of perineural invasion observed in SLAP.

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Acknowledgments

This research was supported by Kyungpook University Research Fund 2009.

Conflict of interest

Hye Jin Kim, Gyu-Seog Choi, Jun Seok Park, Soo Yeun Park, and Soo Han Jun have no conflicts of interest or financial relationships to disclose.

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Authors and Affiliations

  1. Colorectal Cancer Center, Kyungpook National University Medical Center, School of Medicine, Kyungpook National University, 807 Hogukro, Buk-gu, Daegu, 702-210, South Korea

    Hye Jin Kim, Gyu-Seog Choi, Jun Seok Park & Soo Yeun Park

  2. Department of Surgery, Daegu Catholic Medical Center, Catholic University of Daegu, School of Medicine, Daegu, South Korea

    Soo Han Jun

Authors
  1. Hye Jin Kim
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  2. Gyu-Seog Choi
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  3. Jun Seok Park
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Correspondence to Gyu-Seog Choi.

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Kim, H.J., Choi, GS., Park, J.S. et al. Higher rate of perineural invasion in stent–laparoscopic approach in comparison to emergent open resection for obstructing left-sided colon cancer. Int J Colorectal Dis 28, 407–414 (2013). https://doi.org/10.1007/s00384-012-1556-x

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  • DOI: https://doi.org/10.1007/s00384-012-1556-x

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