Short‐ and long‐term outcomes of transanal decompression tube and self‐expandable metallic stent for obstructive colorectal cancer based on a multicenter database (KYCC2110)

AbstractAimThere are well‐known methods for decompressing the colorectal tract before surgery, including transanal decompression tubes (TDT) and self‐expanding metallic stents (SEMS). This study aimed to compare the short and long‐term results in patients with malignant large bowel obstruction in whom TDT or SEMS were placed before surgery.MethodsThis retrospective observational study enrolled 225 patients with malignant large bowel obstruction in whom TDT or SEMS were placed preoperatively and underwent R0 resection between 2008 and 2020. One‐to‐two propensity score matching was performed according to patient characteristics. Short‐ and long‐term outcomes were compared. The primary endpoint was relapse‐free survival (RFS). The secondary endpoints were the overall survival (OS) and postoperative complication rate.ResultsFifty‐seven patients in the TDT group and 114 in the SEMS group were matched. The 3‐year RFS rates were 66.7% in the TDT group and 69.9% in the SEMS group (p = 0.54), and the 3‐year OS rates were 90.5% in the TDT group and 87.1% in the SEMS group (p = 0.52). No significant differences in the long‐term results were observed between the two groups. Regarding short‐term results, the SEMS group had significantly fewer stoma construction (p = 0.007) and shorter postoperative hospitalization (p < 0.001). The incidence of postoperative complications (grade ≥ 2) was significantly lower in the SEMS group (p = 0.04).ConclusionNo significant differences in the long‐term results were observed between the TDT and SEMS group. The SEMS showed significant usefulness in terms of improving short‐term outcomes.