ArticleSurgical endoscopy2026
Short-term outcomes of bridge-to-surgery using self-expanding metallic stents in robotic colorectal surgery for obstructive left-sided colorectal cancer: a consecutive cohort study.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundObstructive colorectal cancer is associated with substantial morbidity and stoma formation. Bridge-to-surgery (BTS) using self-expanding metallic stents (SEMS) can convert emergency surgery into an elective procedure, but evidence in robotic colorectal surgery remains limited. This study evaluated the feasibility of SEMS-based BTS in robotic surgery for obstructive left-sided colorectal cancer.
methodsThis retrospective single-center cohort study included consecutive patients who underwent robotic colorectal resection between February 2023 and December 2025. After excluding right-sided colon cancer, 161 patients were analyzed: 37 underwent BTS and 124 underwent upfront elective surgery. Propensity score matching using preoperative variables generated 36 matched pairs. The primary outcome was major postoperative complications, defined as Clavien-Dindo grade ≥ III complications. Secondary outcomes included perioperative outcomes, robotic intraoperative metrics, and short-term oncological surrogate outcomes.
resultsAfter matching, robotic intraoperative metrics showed no statistically significant differences between the non-BTS and BTS groups, including console time (136.50 vs. 148.00 min, P = 0.166), total operative time (250.00 vs. 274.50 min, P = 0.205), estimated blood loss (3.00 vs. 3.00 mL, P = 0.936), and conversion to open surgery (0% in both groups). Major postoperative complications occurred in one patient (2.8%) in the non-BTS group and in none in the BTS group (P = 1.000). Although the BTS group included more pathologically advanced tumors, R0 resection among patients with Stage I-III disease was achieved in 96.3% and 100.0% of patients, respectively. CEA levels at 3 months postoperatively were not significantly different between groups.
conclusionsSEMS-based BTS appears feasible for selected patients undergoing robotic surgery for obstructive left-sided colorectal cancer. BTS was not accompanied by increased short-term morbidity or measurable intraoperative difficulty after matching. Long-term oncological outcomes require further evaluation.
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