Preoperative decompression for left-sided obstructive colorectal cancer: a comparative study between a stent and a decompression tube

TL;DR

This study compares stents and decompression tubes for preoperative management of left-sided colorectal cancer, finding both methods equally effective and safe.

Contribution

The study provides a direct comparison of clinical and oncological outcomes between stents and decompression tubes in left-sided obstructive colorectal cancer.

Findings

Stents and decompression tubes showed similar technical and clinical success rates.

No significant differences in disease-free or overall survival were observed between the two methods.

Both approaches had low complication rates, with no major oncological safety concerns.

Abstract

Stents and decompression tubes (DTs) are both commonly utilized for preoperative decompression in patients with left-sided obstructive colorectal cancer (OCRC). However, the comparative effectiveness and oncological safety of these 2 approaches remain uncertain.

The aim of this study was to compare clinical performance and long-term oncological outcomes of preoperative stent and DT insertion in patients with left-sided OCRC.

The study included 87 consecutive patients, diagnosed with left-sided OCRC between January 2022 and December 2024. All patients underwent preoperative decompression using either a stent or a DT. Clinical decompression efficacy, surgical outcomes, and oncological parameters were compared between the groups.

Among the 87 patients enrolled, 45 received a stent and 42, a DT. Technical success rates were similar between the groups (stent, 95.6% vs DT, 97.6%; P >0.99), as were clinical success rates (stent, 88.9% vs DT, 90.5%; P >0.99). Perforation occurred in 3 patients (6.7%) in the stent group and 1 participant (2.4%) in the DT group (P = 0.62). Primary anastomosis was achieved in 84.4% of the stent patients and 81% of the DT patients (P = 0.67). Median disease-free survival was 32 (21–43) months in the stent group and 34 (25–43) months in the DT group (P = 0.35), while median overall survival was 38 (29–47) and 39 (34–44) months, respectively (P = 0.53), with no apparent differences between the groups.

Both stent and DT insertion are safe and effective strategies for preoperative left-sided OCRC management. No significant differences in either short-term clinical outcomes or long-term oncological results were observed between the 2 methods.

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