Retrospective Study
Copyright ©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Sep 7, 2014; 20(33): 11826-11834
Published online Sep 7, 2014. doi: 10.3748/wjg.v20.i33.11826
Table 1 Baseline demographic and clinical characteristics of patients n (%)
Total (n = 68)
Age (yr)64.9 (38-89)
Male/female48 (70.6)/20 (29.4)
BMI (kg/m2)22.9 (17.7-31.9)
Previous IA surgery19 (27.9)
Laboratory findings
Hemoglobin (g/dL)12.4 (7.2-17.3)
White blood cells (/mm3)8471.7 (3050-19850)
Albumin (g/dL)3.8 (2.5-5.2)
ASA classification
111 (16.2)
250 (73.5)
37 (10.3)
TNM Stage of tumor
II22 (32.4)
III26 (38.2)
IVA20 (29.4)
Histology
WD8 (11.8)
MD57 (83.8)
PD3 (5.6)
Location of obstruction
Sigmoid flexure5 (7.4)
Descending colon7 (10.3)
Sigmoid-descending area9 (13.2)
Sigmoid colon22 (32.4)
Recto-sigmoid area25 (36.8)
Table 2 Etiology of surgical failure in patients undergoing stenting as a bridge to surgery n (%)
Emergency surgery (n = 8)
Elective surgery (n = 60)
Total (n = 68)
PTRPA(-) (n = 5)PTRPA(+) (n = 3)PTRPA(-) (n = 5)PTRPA(+) (n = 55)
Surgical failure
Technical failure11002 (2.9)
Stent-related complications
Perforation11002 (2.9)
Re-obstruction11001122 (2.9)
Insufficient decompression212105 (7.4)
Unsatisfactory surgical results
PTRPA not feasible00303 (4.4)
Subtotal colectomy00011 (1.5)
Surgical success
Stent-related complications
Insufficient decompression000111 (1.5)
Migration00022 (2.9)
Satisfactory surgical results5050 (73.5)
Table 3 Types of and complications due to operations after colonic stenting as a bridge to surgery n (%)
ComplicationsValue
Type of operation (n = 68)
Anterior resection27 (39.7)
Left hemicolectomy13 (19.1)
Low anterior resection12 (17.6)
Hartmann’s operation7 (10.3)
Subtotal colectomy3 (4.4)
Stoma creation1 (1.5)
Quadrantectomy1 (1.5)
Anterior resection with ileostomy1 (1.5)
Total colectomy1 (1.5)
Low anterior resection with ileostomy1 (1.5)
Segmental resection en bloc1 (1.5)
Surgery-related complications (n = 68)
Wound infection1 (1.5)
Pneumonia1 (1.5)
Anastomosis leakage1 (1.5)
Table 4 Comparison of factors related to surgical failure and success in patients achieving technical success n (%)
Surgical failure(n = 13)Surgical success(n = 53)P value
Patient-related factor
Age > 70 yr6 (46.2)20 (37.7)0.578
Male10 (76.9)36 (67.9)0.727
BMI < 18.5 kg/m23 (23.1)1 (1.9)0.004
Previous IA surgery3 (23.1)16 (30.2)0.612
Anemia9 (69.2)28 (52.8)0.286
Leukocytosis2 (15.4)14 (26.4)0.406
Hypoalbuminemia6 (46.2)11 (20.8)0.061
ASA 1-212 (92.3)47 (88.7)0.703
Tumor-related factor
WD and MD cancer13 (100)50 (94.3)0.380
TNM stage III-IVA12 (92.3)32 (60.4)0.029
Obstructive site0.511
Sigmoid flexure0 (0)5 (9.4)
Descending colon0 (0)6 (11.3)
Sigmoid-descending area2 (15.4)7 (13.2)
Sigmoid colon5 (38.5)17 (32.1)
Recto-sigmoid colon6 (46.2)18 (34.0)
Flexure area8 (61.5)30 (56.6)0.747
Stent-related factor
Uncovered6 (46.2)27 (50.9)0.757
Diameter ≤ 22 (mm)9 (62.5)34 (64.2)0.731
Length ≥ 10 (cm)8 (61.5)27 (50.9)0.493
Multiple SEMS4 (30.8)1 (1.9)< 0.001
Interval from SEMS to surgery (d)9.8 (0-26)12.1 (4-26)0.354
Hospital stay after surgery (d)15.4 (7-44)11.7 (6-55)0.151
Table 5 Multivariate analysis of risk factors for surgical failure in patients achieving technical success
OR95%CIP value
BMI
≥ 18.51 (reference)
< 18.59.7590.784-121.5270.077
TNM stage
II1 (reference)
III and IVA7.6850.666-88.7220.102
Multiple SEMS
No1 (reference)
Yes28.8721.939-429.9560.015