Colonic Self-Expandable Metallic Stents for Patients with Colorectal Cancer Obstruction Induced Sepsis

To determine whether using colonic self-expandable metallic stents (SEMS) as a bridge to surgery for patients with colorectal cancer obstruction induced sepsis (CRCOIS) have better health outcomes compared with emergency surgery (ES). The patients with CRCOIS were enrolled from three university hospitals in China and retrospectively divided into SEMS group (n=32) or ES group (n=20). A total of 52 patients met the inclusion criteria. SEMS group had less the incidence of deep vein thrombosis (P<0.01) and number of organ dysfunction (P<0.01) than ES group. Kaplan-Meier curve showed no significant difference is found in term of 360-day overall survival between the two groups (log-rank test, P = 0.12). However, Multivariable analysis showed the pathological stages (OR: 1.26, 95%CI: 0.72-1.63, P<0.01) and number of organ failure (OR: 0.95, 95%CI: 0.71-1.42, P<0.01) are independent risk factors for 360-day overall survival. Therefore, SEMS placement as a bridge to surgery followed by selective surgery is a feasible and safe procedure for patients with CRCOIS, provides significant advantages of prognosis such as reducing the length of hospital stay, and decreasing the incidence of deep venous thrombosis and organ dysfunction.