# 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.

## Key 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.