Optimal Interval From Placement of a Self-expandable Metallic Stent to Surgery in Patients With Malignant Large Bowel Obstruction: A Preliminary Study

Abstract

Objectives: 

The aim of this study was to investigate the risk factors for postoperative complications (POCs) and optimal interval between a self-expandable metallic stent (SEMS) placement and elective surgery, “bridge to surgery (BTS)” in patients with malignant large bowel obstruction.

Materials and Methods: 

BTS strategy was attempted in 49 patients with malignant large bowel obstruction from January 2013 to March 2017 in our institution. Two of these patients were excluded because they had undergone emergency surgery for SEMS migration.

Results: 

Of these 47 patients, 8 had developed POC (Clavien-Dindo grading ≥II), whereas 39 patients had no such complications. Multivariate analysis identified only the interval between SEMS and surgery as an independent risk factor for POC. Furthermore, a cutoff value of 15 days for interval between SEMS and surgery was identified by receiver operating characteristic curve analysis.

Conclusions: 

An interval of over 15 days is recommended for minimizing POC in patients undergoing elective surgery in a BTS setting.