Self-expandable stent before elective surgery vs. emergency surgery for the treatment of malignant colorectal obstructions: comparison of primary XXXX and morbidity rates.

@entity1 @entity254 @entity694 @entity5
PURPOSE: At present there are not enough studies that demonstrate the usefulness of self-expandable stents in @entity1 with left-sided malignant @entity694 . We evaluated primary @entity254 and morbidity rates obtained with this method in comparison with the results of the emergency surgical treatment. METHODS: From February 1994 to November 1999, 72 consecutive @entity1 with left-sided malignant colorectal obstruction were enrolled. Forty-three @entity1 were assigned to the study group (preoperative stent and elective surgical treatment or palliative stent, depending on the assessment of the stage of the @entity5 ) and 29 to the control group (emergency surgical treatment). The resection was not indicated in 18 cases in the study group (after preoperative staging in 17 and intraoperative staging in 1) and in 3 cases in the control group. RESULTS: In the study group, the obstruction was relieved in 41 cases (95 percent) after the stent placement. Of 26 @entity1 who underwent surgical treatment, a primary @entity254 was possible in 22 (84.6 vs. 41.4 percent in the control group, P = 0.0025), with lower need for a colostomy (15.4 vs. 58.6 percent in the control group). The anastomotic failure rate was similar and the reintervention rate was lower (0 vs. 17 percent, P = 0.014). The total stay (14.23 vs. 18.52 days; P = 0.047), the intensive care unit stay (0.3 vs. 2.9 days; P = 0.015), and the number of @entity1 with severe complications (11.6 vs. 41.2 percent; P = 0.008) were significantly lower in the study group. CONCLUSIONS: In our @entity1 with left-sided malignant @entity694 , placement of a preoperative stent prevented 17 (94 percent) of 18 of unnecessary operations and a large number of colostomies after elective surgery. These results were obtained with a lower severe complication rate as well as a shorter hospital stay.
