Trattamento delle stenosi neoplastiche del colon sinistro: endoprotesi autoespadibili prechirurgia vs chirurgia d'urgenza. Confronto di risultati e tassi di sopravvivenza.

In recent years there has been a substantial increase in the use of self-expandable metal stent endoprostheses for preoperative "bridge to surgery" treatment of obstructive colorectal cancer. Stent insertion for malignant tumours is still controversial because of the increased risk of metastasis and regional advance of the cancer. We compared the short-term results and long-term survival times with preoperative stent insertion vs emergency surgery without stents. From January 2004 to December 2005, 16 patients (9 stent+surgery vs 7 emergency surgery) were admitted to our emergency department with obstructive colon cancer. There was no significant difference in general condition (age and comorbidity) or in cancer classification between the two groups. The percentage of resections with primary anastomosis was significantly higher in the stent group and the percentage of stoma creation significantly lower in the stent group. There was no significant difference in prognosis between the two groups. Because preoperative expandable metal stent insertion for obstructive colorectal cancer had better postoperative results and no disadvantages in terms of long-term prognosis, the Authors recommend this procedure for the preoperative treatment of obstructive colorectal cancer.