Influence of endoscopists' expertise level on clinical outcomes after bridge‐to‐surgery stenting in obstructive colorectal cancer

Abstract

AbstractBackground and AimThis study aimed to investigate the effect of stenting‐related factors, including endoscopists' expertise, on clinical outcomes after bridge‐to‐surgery (BTS) stenting for obstructive colorectal cancer (CRC).MethodsWe analyzed BTS stenting‐related factors, including stenting expertise and the interval between stenting and surgery, in 233 patients (63 [13] years, 137 male) who underwent BTS stenting for obstructive CRC. We evaluated the influence of these factors on post‐BTS stenting clinical outcomes such as stent‐related complications and cancer recurrence.ResultsThe interval between stenting and surgery was ≤ 7 days in 79 patients (33.9%) and > 7 days in 154 patients (66.1%). BTS stenting was performed by endoscopists with ≤ 50, 51–100, and > 100 prior stenting experiences in 94, 43, and, 96 patients, respectively. The clinical success rate of BTS stenting was 93.1%. Stent‐related and postoperative complications developed in 19 (8.2%) and 20 (8.6%) patients, respectively. Cancer recurrence occurred in 76 patients (32.6%). Short BTS interval of ≤ 7 days increased the risk of postoperative complications (odds ratio [OR], 2.61 [1.03–6.75]; P = 0.043). Endoscopists' stenting experience > 100 showed greater clinical success of stenting (OR, 5.50 [1.45–28.39]; P = 0.021) and fewer stent‐related complications (OR, 0.26 [0.07–0.80]; P = 0.028) compared with stenting experience ≤ 50. BTS stenting‐related factors did not affect long‐term oncological outcomes.ConclusionGreater expertise of endoscopists was associated with better short‐term outcomes, including high stenting success rate and low rate of stent‐related complications after BTS stenting for obstructive CRC. An interval of > 7 days between BTS stenting and surgery was required to decrease postoperative complications.