J Korean Surg Soc.  2013 Dec;85(6):290-295. 10.4174/jkss.2013.85.6.290.

Feasibility and safety of laparoscopic resection following stent insertion for obstructing left-sided colon cancer

• Rho SY
• Bae SU
• Baek SJ
• Hur H
• Min BS
• Baik SH
• Lee KY
• Kim NK

• KMID: 2212553
• DOI: http://doi.org/10.4174/jkss.2013.85.6.290

Abstract

PURPOSE
The aim of this study was to assess the feasibility and safety of laparoscopic resection following the insertion of self-expanding metallic stents (SEMS) for the treatment of obstructing left-sided colon cancer.
METHODS
Between October 2006 and December 2012, laparoscopic resection following SEMS insertion was performed in 54 patients with obstructing left-sided colon cancer.
RESULTS
All 54 procedures were technically successful without the need for conversion to open surgery. The median interval from SEMS insertion to laparoscopic surgery was 9 days (range, 3-41 days). The median surgery time was 200 minutes (range, 57-444 minutes), and estimated blood loss was 50 mL (range, 10-3,500 mL). The median time to soft diet was 4 days (range, 2-8 days) and possible length of stay (hypothetical length of stay according to the discharge criteria) was 7 days (range, 4-22 days). The median total number of lymph nodes harvested was 23 (range, 8-71) and loop ileostomy was performed in 2 patients (4%). Six patients (11%) developed postoperative complications: 2 patients with anastomotic leakages, 1 with bladder leakage, and 3 with ileus. There was no mortality within 30 days.
CONCLUSION
The present study shows that the presence of a SEMS does not compromise the laparoscopic approach. Laparoscopic resection following stent insertion for obstructing left-sided colon cancer could be performed with a favorable safety profile and short-term outcome. Large-scale comparative studies with long-term follow-up are needed to demonstrate a significant benefit of this approach.

Keyword

Colonic neoplasms; Stents; Laparoscopy

MeSH Terms

Anastomotic Leak
Colon*
Colonic Neoplasms*
Conversion to Open Surgery
Diet
Humans
Ileostomy
Ileus
Laparoscopy
Length of Stay
Lymph Nodes
Mortality
Postoperative Complications
Stents*
Urinary Bladder

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