Table 2. Procedural Characteristics and Short-term Treatment Outcomes (Within 90 Days After Resection) of Propensity Score–Matched Samplesa.
| Characteristic or Outcome | DS as BTS (n = 121) | SEMS as BTS (n = 121) | cOR (95% CI) | P Value |
|---|---|---|---|---|
| Time from first presentation to DS or SEMS, median (IQR), d | 1.0 (0.0-2.0) | 1.0 (0.0-1.0) | 0.82 (0.67-1.00) | .05 |
| Time from DS or SEMS to resection in days, median (IQR), d | 30.0 (19.0-47.0) | 18.0 (8.0-30.8) | 0.95 (0.93-0.97) | <.001 |
| Laparoscopic approach for primary tumor resection | 60/121 (49.6) | 62/120 (51.7) | 1.07 (0.65-1.74) | .80 |
| Surgical procedure | .44 | |||
| Sigmoid resection | 81/121 (66.9) | 84/121 (69.4) | 1.13 (0.65-1.98) | .67 |
| Left hemicolectomy | 31/121 (25.6) | 33/121 (27.3) | 1.10 (0.60-2.02) | .76 |
| Subtotal colectomy | 6/121 (5.0) | 3/121 (2.5) | NAb | .51b |
| Extended left hemicolectomy | 3/121 (2.5) | 0/121 (0.0) | NAc | NAc |
| Transverse resection | 0/121 | 1/121 (0.8) | NAc | NAc |
| Completeness of resection | .53 | |||
| R0 | 116/121 (95.9) | 112/114 (98.2) | 2.50 (0.49-12.89) | .27 |
| R1 | 5/121 (4.1) | 1/114 (0.9) | NAb | .22b |
| R2 | 0/121 | 1/114 (0.9) | NAc | NAc |
| No. of lymph nodes harvested, median (IQR) | 15.0 (12.0-21.0) | 19.0 (14.0-24.0) | 1.04 (1.01-1.07) | .01 |
| No. of positive lymph nodes harvested, median (IQR) | 1.0 (0.0-3.0) | 1.0 (0.0-3.0) | 1.02 (0.95-1.10) | .57 |
| Angioinvasion | 31/106 (29.2) | 34/113 (30.1) | 1.05 (0.56-1.97) | .87 |
| Extramural venous invasion | 23/106 (21.7) | 31/113 (27.4) | 1.39 (0.68-2.83) | .37 |
| Lymphatic invasion | 6/106 (5.7) | 2/111 (1.8) | NAb | .45b |
| Intramural venous invasion | 2/106 (1.9) | 1/113 (0.9) | NAb | >.99b |
| Stoma in situ directly after tumor resection | 81/121 (66.9) | 34/117 (29.1) | 0.15 (0.07-0.32) | <.001 |
| (New) stoma constructed during resection | 13/81 (16.0) | 34/34 (100) | NA | NA |
| Type of stoma in situ directly after tumor resection | .01 | |||
| Diverting ileostomy | 9/77 (11.7)d | 4/34 (11.8) | 0.50 (0.09-2.73) | .42 |
| End ileostomy | 4/77 (5.2) | 2/34 (5.9) | NAb | >.99b |
| Diverting colostomy | 57/77 (74.0) | 0/34 | NAc | NAc |
| End colostomy | 7/77 (9.1) | 28/34 (82.4) | 65.29 (1.63-2611.50) | .03 |
| Primary anastomosis | 104/121 (86.0) | 90/120 (75.0) | 0.41 (0.19-0.89) | .02 |
| Hospital stay during BTS interval, median (IQR), d | ||||
| Directly after DS or SEMS without readmissions | 7.0 (5.0-12.0) | 4.0 (2.0-6.0) | 0.85 (0.79-0.92) | <.001 |
| Readmission during BTS interval | 2/111 (1.8) | 1/113 (0.9) | NAb | >.99b |
| Including readmissions during BTS interval | 7.0 (5.0-12.0) | 4.0 (2.0-6.0) | 0.86 (0.79-0.92) | <.001 |
| Hospital stay directly after resection, median (IQR), de | 7.0 (5.0-9.0) | 7.0 (5.0-14.0) | 1.03 (1.00-1.06) | .09 |
| BTS-related complications during bridging interval | 13/116 (11.2) | 8/115 (7.0) | 0.78 (0.29-2.09) | .62 |
| SEMS-related perforation | NA | 9/112 (8.0) | NA | NA |
| Resection-related complications within 90 d | 24/121 (19.8) | 34/118 (28.8) | 1.56 (0.86-2.81) | .14 |
| Major resection–related complications | 7/121 (5.8) | 18/118 (15.3) | 3.20 (1.17-8.74) | .02 |
| Anastomotic leakage | 3/104 (2.9) | 5/90 (5.6) | NAb | >.99b |
| Abscess (intra-abdominal) | 2/121 (1.7) | 7/121 (5.8) | NAb | .18b |
| Fascia dehiscence | 3/119 (2.5) | 5/118 (4.2) | NAb | .73b |
| Wound infection | 13/120 (10.8) | 6/117 (5.1) | 0.42 (0.15-1.18) | .10 |
| Postoperative ileus | 4/120 (3.3) | 9/117 (7.7) | NAb | .27b |
| Gastroparesis | 0/120 | 4/117 (3.4) | NAc | NAc |
| Bleeding | 0/120 | 2/117 (1.7) | NAd | NAc |
| 90-d Complication ratef | 34/118 (28.8) | 39/114 (34.2) | 1.27 (0.73-2.23) | .40 |
| 90-d Subsequent intervention rateg | 8/112 (7.1) | 16/115 (13.9) | 2.33 (0.90-6.07) | .08 |
| 90-d Mortality | 2/121 (1.7) | 6/121 (5.0) | NAb | .29b |
| Adjuvant chemotherapy | 47/120 (39.2) | 54/121 (44.6) | 1.26 (0.76-2.09) | .37 |
| Time from resection until start of adjuvant chemotherapy, median (IQR), wk | 5.0 (4.0-7.0) | 7.0 (4.0-9.5) | 1.13 (0.91-1.39) | .28 |
Abbreviations: BTS, bridge to surgery; cOR, conditional odds ratio; DS, decompressing stoma; IQR, interquartile range; NA, not applicable; SEMS, self-expandable metal stent.
Data are presented as number/total number (percentage) of patients unless otherwise indicated.
McNemar test instead of conditional logistic regression because of fewer than 5 observations; therefore, no cOR and 95% CI were reported.
Because of 0 observations in 1 or both group(s), no P value could be calculated with the McNemar test.
Type of stoma in situ directly after tumor resection missing for 4 patients undergoing DS.
Without readmissions.
Combination of complications after BTS and less than 90 days after resection.
Additional interventions within the BTS interval or less than 90 days after resection solely because of complications, excluding complications related to the stoma in situ after resection and excluding stoma reversals.