EP904 - Self-Expandable Metal Stents as a Bridge to Elective Surgery in Obstructing Left-Sided Colorectal Cancer: A Decade of Experience

Senior Author(s)

• MK

  Mahwish Khawar, n/a

  Colorectal Surgeon
  Department of Colorectal surgery, Hamad General Hospital, Doha, Qatar
  Doha, Ad Dawhah, Qatar

  Disclosure information not submitted.

Author(s)

• MA

  Mahmood Al-Dhaheri, n/a

  Colorectal Surgeon
  Department of Colorectal surgery, Hamad General Hospital, Doha, Qatar
  Doha, Ad Dawhah, Qatar

  Disclosure information not submitted.
• IA

  Ibrahim Amer, n/a

  Colorectal Surgeon
  Department of Colorectal surgery, Hamad General Hospital, Doha, Qatar
  Doha, Ad Dawhah, Qatar

  Disclosure information not submitted.
• AA

  Ammar Aleter, n/a

  Colorectal Surgeon
  Department of Colorectal surgery, Hamad General Hospital, Doha, Qatar
  Doha, Ad Dawhah, Qatar

  Disclosure information not submitted.
• At

  Ali toffaha, n/a

  Colorectal Surgeon
  Department of Colorectal surgery, Hamad General Hospital, Doha, Qatar
  D, Ad Dawhah, Qatar

  Disclosure information not submitted.
• MA

  Mohamed Abu Nada, n/a

  Colorectal Surgeon
  Department of Colorectal surgery, Hamad General Hospital, Doha, Qatar
  Doha, Ad Dawhah, Qatar

  Disclosure information not submitted.

ePoster Presenter(s)

• 

  Youssuf Khanafer

  Medical Student
  College of Medicine, Qatar University
  Qatar University
  Doha, Ad Dawhah, Qatar

  Disclosure information not submitted.

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Author(s)

• AP

  Amjad Parvaiz, n/a

  Colorectal Surgeon
  Poole General Hospital, Poole United Kingdom
  Doha, Ad Dawhah, Qatar

  Disclosure information not submitted.

Purpose/Background: Colorectal cancer accounts for approximately 10% of all cancer cases and deaths. Among these, left-sided lesions are frequently complicated by malignant obstruction, representing a critical surgical challenge. Self-expandable metallic stents (SEMS) have emerged as an effective bridge to elective surgery, however, regional outcomes from Middle Eastern centers remain underreported. This study aims to evaluate the safety, efficacy, and surgical outcomes of SEMS placement in patients presenting with malignant left-sided colonic obstruction at a tertiary referral center in the Middle East, contributing valuable regional insight into this evolving management strategy.

Methods/Interventions: We conducted a retrospective single-center study of patients with obstructing colorectal cancer who underwent SEMS placement between January 2015 and January 2024 at a tertiary colorectal unit. Patients with lesions from the transverse colon to the rectosigmoid junction were included. Primary outcomes included stent success, conversion to elective surgery, surgical approach, stoma formation, complications, and oncological outcomes.

Results/Outcomes: Over a 10-year period, a total of 110 patients diagnosed with obstructing left-sided colon cancer (71 males and 39 females with a median age of 54 years) were treated at our institution with self-expanding metallic stent (SEMS) placement as the initial management approach, achieving a technical success rate of 90.9%. Of these patients, seventy-one (64.5%) proceeded to surgical resection, of whom 81.7% underwent elective surgery. All elective resections were performed minimally invasively (54 laparoscopic, 4 robotic), with a 12.1% conversion rate. Overall stoma formation was 22.5%, significantly lower in elective (2 cases) vs. emergency (14 cases) surgeries. Postoperative morbidity was 19.7%, and one patient died within 30 days of surgery. Within the cohort, 64 patients achieved disease-free status at follow-up, however, twenty-one experienced recurrence. Twenty-six patients (23.6%) underwent palliative stenting without resection, and follow-up data were unavailable in 20% of patients.

Conclusion/Discussion: Colonic stenting as a bridge to surgery facilitated high rates of elective minimally invasive resections and markedly reduced emergency surgeries and stoma formation. Our institutional decade-long experience supports SEMS as a safe, effective, and oncologically sound strategy in selected patients with obstructing colorectal cancer. The consistent reduction in postoperative morbidity and enhanced recovery further highlight its clinical value. Nevertheless, prospective multicenter studies are needed to further define long-term outcomes.

Summary of Surgical and Oncologic Outcomes After SEMS Placement (N=110)
This table summarizes surgical resections, perioperative outcomes, and follow-up data for patients who underwent self-expanding metal stent (SEMS) placement.