To compare stent placement as a bridge to surgery vs. emergency surgical resection in patients with acute left-sided colorectal cancer obstruction using P-POSSUM and CR-POSSUM.
From January 2008 to December 2009, the physiological and operative scores, morbidity and mortality predicted by the P-POSSUM and CR-POSSUM scores were collected in all consecutive patients with LCCO who underwent surgical resection directly (Group A) or after stent placement (Group B).
Eighty-six patients were enrolled (Group A-41 and Group B-45). The observed 30-day mortality rate was 9.8%(4/41) in Group A and 2.4%(1/45) in Group B. The 30-day morbidity rate was 61%(25/41) in Group A and 29%(13/45) in Group B. The mean values of P-POSSUM morbidity (A = 70.5%vs. B = 34.3%; p = 0.001), P-POSSUM mortality (A = 13.6%vs. B = 2.4%; p = 0.001) and CR-POSSUM mortality (A = 15.1%vs. B = 4.9%; p = 0.001) were significantly lower in the Group B patients than in the Group A patients.
Bridge to surgery strategy reduces the surgical risks in LCCO, and P-POSSUM and CR-POSSUM scores represent a good tool for comparing the two strategies.