The Optimal Surgery Timing After Stenting in Colorectal Cancer Patients with Malignant Obstruction: Additionally Compared with Emergency Surgery

Abstract Background and study aim The optimal surgery timing after stenting remains unclear in colorectal cancer (CRC) patients with malignant obstruction. The objective of this study was to compare short-term and long-term outcomes according to the time interval after stenting. These outcomes were also compared with those of emergency surgery (ES). Patients and methods CRC patients with malignant obstruction who had obstructive symptoms between January 2008 and July 2018 were reviewed retrospectively, including 133 patients who visited the emergency room and subsequently underwent ES and 220 patients initially treated with stenting who subsequently underwent elective surgery. The time interval between self-expandable metal stent (SEMS) placement and elective surgery was classified as < 11 days, 11–17 days, and > 17 days. Short-term and long-term outcomes were compared. Results For those who received SEMS, the group with time interval of 11–17 days had fewer hospital days than the group with time interval < 11 days and the proportion of stoma formation was lower than that in the group with time interval of > 17 days. Multivariable analysis revealed a decreased risk of death only in the group with time interval of 11–17 days compared to the ES group (HR: 0.48; 95% CI: 0.24–0.97). Disease-free survival was comparable between time interval groups and the ES group (log-rank P = 0.52). Conclusions Approximately two weeks of the time interval after stenting to the elective surgery was reasonable.