To compare the operative and oncological results of decompressing stoma and stent as a bridge to surgery for the curative treatment of obstructive left-sided colonic cancer.

A total of 156 consecutive patients with obstructive left-sided colonic cancer in the period January 2002 to December 2018 from Beijing Chao-yang Hospital who underwent radical resection with curative intent were retrospectively reviewed. Patients were divided into two groups: stoma group (n=70) and stent group (n=86). The short- and long-term outcomes between the groups were compared.

The tumor size was larger (t=2.679, P＜0.05) and more tumors located at splenic flexure in the stoma group (χ2=12.031, P＜0.05). Both groups had similar demographic and tumor characteristics in terms of age, gender, body mass index, and tumor stage (all P＞0.05). The mean operating time was longer (t=3.276, P＜0.05) and postresection stomas were more often in the stoma group (χ2=10.309, P＜0.05). The following terms were similar between two groups, including blood loss, the rate of laparoscopic surgery, overall postoperative complication rate, peri-operative mortality, permanent colostomy rate (all P＞0.05). More patients in the stent group had local recurrence during follow-up (23.3% vs. 8.6%, χ2=5.991; P=0.014). The 5-year disease-free survival (45.7% vs 74.7%, χ2=6.851; P=0.009) and overall survival (67.2% vs. 79.4%, χ2=4.900; P=0.027) were significantly lower in the stent group.

Although endoscopic stenting is associated with better surgical outcomes than decompressing stoma, it may negatively impact oncologic results. A randomized clinical trial that compares the two bridging techniques is needed.