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Study Finds Stent, Laparoscopy Superior to Open Surgery

Stenting opens bowel pathway, helps avoid emergency surgery for obstructing colon cancer

THURSDAY, Dec. 24 (HealthDay News) -- Instead of performing emergency open surgery on a colon cancer patient with an obstructing tumor, placement of a metal stent can open a bowel pathway until the tumor is removed via less invasive laparoscopy, according to a study in the December issue of the Archives of Surgery.

Hester Yui Shan Cheung, of the Pamela Youde Nethersole Eastern Hospital in Hong Kong, and colleagues randomized 48 patients with left-side colon cancer and an obstructing tumor to be treated by either endoluminal stenting with self-expanding metal stents followed within two weeks by laparoscopic resection, or emergency open surgery the same day as admission. Outcome measures included a successful single-stage operation, cumulative duration of the operation, amount of blood loss, hospital stay, pain and complications.

The researchers found that the patients in the stent and laparoscopy group had less blood loss than the open-surgery group, as well as less pain, decreased incidence of anastomotic leak, and less infection. Also, more patients in the stent and laparoscopy group had a successful one-stage operation and none had a permanent stoma compared to six patients with stoma in the open-surgery group.

"Self-expanding metal stents serve as a safe and effective bridge to subsequent laparoscopic surgery in patients with obstructing left-sided colon cancer. This endolaparoscopic approach makes a one-stage operation more feasible, is associated with reduced incidence of stoma creation, and allows patients with malignant large-bowel obstruction to enjoy the full benefit of minimally invasive surgery," the authors write.

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