Colonic Stenting vs Emergency Surgery for Colonic Obstruction
Author Information
Author(s): van Hooft Jeanin E, Bemelman Willem A, Breumelhof Ronald, Siersema Peter D, Kruyt Philip M, van der Linde Klaas, Veenendaal Roeland A, Verhulst Marie-Louise, Marinelli Andreas W, Gerritsen Josephus JGM, van Berkel Anne-Marie, Timmer Robin, Grubben Marina JAL, Scholten Pieter, Geraedts Alfons AM, Oldenburg Bas, Sprangers Mirjam AG, Bossuyt Patrick MM, Fockens Paul
Primary Institution: Academic Medical Center, Amsterdam, The Netherlands
Hypothesis
Is colonic stenting followed by elective surgery more effective than emergency surgery for managing acute left-sided malignant colonic obstruction?
Conclusion
The study aims to determine if colonic stenting as a bridge to surgery improves outcomes compared to emergency surgery.
Supporting Evidence
- Colonic stenting has been suggested to decrease mortality and morbidity in patients with malignant colonic obstruction.
- Emergency surgeries have a high mortality rate of 15-34% and morbidity rate of 32-64%.
- Stenting allows for better tumor staging and may avoid unnecessary surgeries.
Takeaway
Doctors want to find out if putting a stent in the colon before surgery is better than doing surgery right away for patients with a blocked colon.
Methodology
Patients with acute left-sided malignant colonic obstruction will be randomized to either emergency surgery or colonic stenting as a bridge to elective surgery, with outcomes measured in terms of quality of life, morbidity, and mortality.
Potential Biases
Potential selection bias due to the nature of the randomized trial and the experience of the surgeons.
Limitations
The study may be limited by the experience level of the gastroenterologists performing the stent placements.
Participant Demographics
Patients with acute left-sided malignant colonic obstruction, aged over 18.
Statistical Information
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website