PTU-126 Results of using colorectal SEMS vs decompression tube as bridge to surgery: comparative randomized trail

Introduction Despite advances in screening and early diagnosis, about 15% of colorectal cancers present with acute colonic obstruction. Emergency colorectal surgery is associated with high morbidity and mortality rates. Preoperative decompression (SEMS or trananal decompression tube placement) as a bridge to surgery has been reported to improve short-term outcomes. However, oncological safety of endoscopic interventions is debatable due to the high frequency of perforations and dissemination. There are few retrospective studies of comparative outcomes between SEMS and decompression tube, but the benefits were not clear. The aim of this prospective randomized study is to compare sort-term and especially long term outcome of colorectal stenting and transanal decompression tube as a bridge to surgery. Methods Between December 2012 and December 2017, 72 patients with malignant colon obstruction, which was diagnosed based on radiological and endoscopic findings with pathohistological examination, were consecutively included into the study. Patients were randomized of random sampling numbers and divided into the stent or decompression tube group. Results Technical success rate RR 0.914, 95% CI 0.804–1.039 (p=0.065). Clinical success was significant higher in stent group RR 0.643, 95% CI 0.489–0.846 (p=0.031). Rate of complications was similar in groups RR 0.895, 95% CI 0.755–1.061 (p=0.087). Short-term outcomes in SEMS group were superior to decompression tube group in the following areas: stoma creation rate RR 0.914, 95% CI 0.804–1.039 (p=0.065) (p Conclusions SEMS has some benefits in comparison with decompression tubes in the short-term postoperative period for patients with malignant colorectal obstruction. The overall recurrence rate was higher in the stent group in long-term period. Moreover, the overall survival rate in the group is no different. Need to continue research to material accumulation and analysis of long-term results.