Retrospective Study
Copyright ©The Author(s) 2022.
World J Gastrointest Endosc. Nov 16, 2022; 14(11): 704-717
Published online Nov 16, 2022. doi: 10.4253/wjge.v14.i11.704
Table 1 Clinical and pathological features of patients with colorectal cancer according to decompression methods
Characteristic1All cases (n = 102)Decompression methods
P value2
Transanal tube (n = 76)
SEMS (n = 26)
Sex, n (%)0.91
Female 54 (53)40 (53)14 (54)
Male48 (47)36 (47)12 (46)
Age, mean ± SD (years)72.6 ± 12.571.7 ± 12.975.1 ± 11.10.24
Tumor location, n (%)0.24
Cecum to transverse colon16 (16)13 (17)3 (12)
Descending to sigmoid colon65 (64)45 (59)20 (77)
Rectum21 (21)18 (24)3 (12)
Tumor size, mean ± SD (mm)40.7 ± 16.239.0 ± 14.945.4 ± 19.30.086
Time from decompression to operation, mean ± SD (days)13.6 ± 12.912.0 ± 7.618.2 ± 21.70.035
Histological type, n (%)0.35
Well 29 (28)19 (25)10 (38)
Moderate 67 (66)53 (70)14 (54)
Mucinous, poor, or signet-ring cell6 (5.9)4 (5.3)2 (7.7)
T stage (depth of tumor invasion), n (%)0.57
T1 (submucosa)---
T2 (muscularis propria)1 (1.0)-1 (3.9)
T3 (subserosa)67 (66)54 (71)13 (50)
T4 (serosa or other organs)34 (33)22 (29)12 (46)
N stage (number of positive lymph nodes), n (%)0.54
N0 (0)49 (48)36 (47)13 (50)
N1 (1-3)39 (38)28 (37)11 (42)
N2 (4-)14 (14)12 (16)2 (7.7)
AJCC disease stage, n (%)0.40
I1 (1.0)-1 (3.9)
II42 (41)31 (41)11 (42)
III36 (35)27 (36)9 (35)
IV23 (23)18 (24)5 (19)
Mutation status, n (%)0.51
KRAS mutated34 (43)26 (47)8 (33)
NRAS mutated3 (3.8)2 (3.6)1 (4.2)
BRAF mutated0 (0)0 (0)0 (0)
Absent42 (53)27 (49)15 (63)
1Percentage indicates the proportion of patients with a specific clinical characteristic among all patients or in strata of decompression methods.
2We used the chi-square test to compare categorical variables and analysis of variance to compare continuous variables. We adjusted the two-sided α level to 0.05.
AJCC: American Joint Committee on Cancer; SEMS: Self-expanding metal stent.
Table 2 Perioperative features of patients with colorectal cancer according to decompression methods
Characteristic1All cases (n = 102)Decompression methods
P value2
Transanal tube (n = 76)
SEMS (n = 26)
Operation method, n (%)0.31
Open54 (53)38 (50)16 (62)
Laparoscopy48 (47)38 (50)10 (38)
Conversion to laparotomy, n (%)0.072
Absent47 (98)38 (100)9 (90)
Present1 (2.1)-1 (10)
Procedure, n (%)0.17
Colectomy58 (57)44 (58)14 (54)
Anterior resection37 (36)25 (33)12 (46)
Hartmann procedure5 (4.9)5 (6.6)-
Abdominoperineal resection (Miles’ operation)2 (2.0)2 (2.6)-
Lymph node dissection, n (%)0.35
D13 (2.9)3 (4.0)-
D210 (9.8)8 (11)2 (7.7)
D389 (87)65 (86)24 (92)
Reconstruction (except 2 abdominoperineal resection cases), n (%)0.011
Absent10 (10)10 (14)-
Present90 (90)64 (86)26 (100)
Number of harvested lymph nodes, mean ± SD21.6 ± 12.021.5 ± 11.821.7 ± 12.60.97
Operation time, mean ± SD (min)241 ± 80234 ± 79263 ± 790.12
Blood loss, mean ± SD (g)224 ± 364229 ± 375212 ± 3360.84
Clavien-Dindo classification, n (%)0.22
078 (76)58 (76)20 (77)
15 (4.9)5 (6.6)-
211 (11)8 (11)3 (12)
37 (7.7)5 (6.6)2 (7.7)
4---
51 (1.0)-1 (3.9)
Postoperative hospitalization, mean ± SD (days)18.8 ± 15.119.3 ± 17.017.2 ± 6.70.53
Postoperative chemotherapy, n (%)0.36
Absent51 (50)36 (47)15 (58)
Present51 (50)40 (53)11 (42)
1Percentage indicates the proportion of patients with a specific clinical characteristic among all patients or in strata of decompression methods.
2We used the chi-square test to compare categorical variables and analysis of variance to compare continuous variables. We adjusted the two-sided α level to 0.05.
SEMS: Self-expanding metal stent.
Table 3 Pathological features of patients with colorectal cancer according to decompression methods
Characteristic1All cases (n = 102)Decompression methods
P value2,3
Transanal tube (n = 76)
SEMS (n = 26)
Lymphatic invasion, n (%)0.12 (0.020)
Absent11 (11)10 (13)1 (3.9)
Minimal41 (40)33 (43)8 (31)
Moderate32 (31)23 (30)9 (35)
Severe18 (18)10 (13)8 (31)
Venous invasion, n (%)< 0.0001 (0.0002)
Absent19 (19)17 (22)2 (7.7)
Minimal45 (44)37 (49)8 (31)
Moderate23 (23)19 (25)4 (15)
Severe15 (15)3 (4.0)12 (46)
1Percentage indicates the proportion of patients with a specific clinical characteristic among all patients or in strata of decompression methods.
2We used the chi-square test to compare as categorical variables. We adjusted the two-sided α level to 0.05.
3We used the Mann-Whitney U test to compare as nonparametric continuous variables. We adjusted the two-sided α level to 0.05.
SEMS: Self-expanding metal stent.
Table 4 Pathological features of patients with colorectal cancer according to decompression methods in strata of American Joint Committee on Cancer-pT stage or tumor location
Characteristic1All cases (n = 102)Decompression methods
P value2,3
Transanal tube (n = 76)
SEMS (n = 26)
Lymphatic invasion
AJCC-pT2/T3 cases, n (%)0.024 (0.036)
Absent8 (12)8 (15)-
Minimal31 (46)25 (46)6 (43)
Moderate20 (29)17 (31)3 (21)
Severe9 (13)4 (7.4)5 (36)
AJCC-pT4 cases, n (%)0.53 (0.56)
Absent3 (8.8)2 (9.1)1 (8.3)
Minimal10 (29)8 (36)2 (17)
Moderate12 (35)6 (27)6 (50)
Severe9 (26)6 (27)3 (25)
Venous invasion
AJCC-pT2/T3 cases, n (%)0.0031 (0.0025)
Absent13 (19)12 (22)1 (7.1)
Minimal37 (54)32 (59)5 (36)
Moderate12 (18)9 (17)3 (21)
Severe6 (8.8)1 (1.9)5 (36)
AJCC-pT4 cases, n (%)0.0077 (0.042)
Absent6 (18)5 (23)1 (8.3)
Minimal8 (24)5 (23)3 (25)
Moderate11 (32)10 (45)1 (8.3)
Severe9 (26)2 (9.1)7 (58)
Lymphatic invasion
Cecum to transverse colon cases, n (%)0.21 (0.088)
Absent3 (19)3 (23)-
Minimal7 (44)6 (46)1 (33)
Moderate4 (25)4 (31)-
Severe2 (13)-2 (67)
Descending to rectum, n (%)0.40 (0.096)
Absent8 (9.3)7 (11)1 (4.4)
Minimal34 (40)27 (43)7 (30)
Moderate28 (33)19 (30)9 (39)
Severe16 (19)10 (16)6 (26)
Venous invasion
Cecum to transverse colon cases, n (%)0.10 (0.078)
Absent5 (31)5 (38)-
Minimal6 (38)5 (38)1 (33)
Moderate2 (13)2 (15)-
Severe3 (19)1 (7.7)2 (67)
Descending to rectum, n (%)0.0001 (0.0012)
Absent14 (16)12 (19)2 (8.7)
Minimal39 (45)32 (51)7 (30)
Moderate21 (24)17 (27)4 (17)
Severe12 (14)2 (3.2)10 (43)
1Percentage indicates the proportion of patients with a specific clinical characteristic among all patients or in strata of decompression methods.
2We used the chi-square test to compare as categorical variables. We adjusted the two-sided α level to 0.05.
3We used the Mann-Whitney U test to compare as nonparametric continuous variables. We adjusted the two-sided α level to 0.05.
AJCC: American Joint Committee on Cancer; SEMS: Self-expanding metal stent.
Table 5 Logistic regression analyses to assess the association of decompression method (predictor) with severe venous invasion (outcome)
Model for severe venous invasion (n = 102, as a binary outcome variable)Univariable
Multivariable1
Multivariable2
OR (95%CI)
P value
OR (95%CI)
P value
OR (95%CI)
P value
Decompression methods
Transanal tube1 (reference)< 0.00011 (reference)< 0.00011 (reference)< 0.0001
SEMS20.9 (5.78-101)19.4 (5.24-96.2)36.7 (7.89-259)
Age (for 10-yr increment)1.29 (0.82-2.20)0.28
Sex
Female1 (reference)0.60
Male1.34 (0.44-4.14)
Tumor location
Cecum to transverse colon1 (reference)0.271 (reference)0.27
Descending to sigmoid colon0.88 (0.23-4.31)0.38 (0.05-2.60)
Rectum0.22 (0.01-1.90)0.11 (0.003-1.58)
Waiting period (for 1-wk increment)0.91 (0.47-1.22)0.64
Tumor size (for 10-mm increment)1.10 (0.78-1.49)0.55
Histological type
Well 1 (reference)0.211 (reference)0.065
Moderate 2.65 (0.65-17.9)7.27 (1.27-64.5)
Mucinous, poor, or signet-ring cell6.75 (0.66-72.0)10.7 (0.48-342)
AJCC-pT
T2/T31 (reference)0.0211 (reference)0.0841 (reference)0.082
T43.72 (1.22-12.2)3.17 (0.86-12.6)3.76 (0.85-19.4)
Mutation
Absent1 (reference)0.81
Present (KRAS, NRAS)1.16 (0.33-4.07)
1The multivariable logistic regression model included the decompression method (transanal tube vs SEMS), and AJCC-pT (T2/T3 vs T4).
2The multivariable logistic regression model included the decompression method (transanal tube vs SEMS), tumor location (cecum to transverse colon vs descending to sigmoid colon vs rectum), histological type (well-differentiated vs. moderately differentiated vs others), and AJCC-pT (T2/T3 vs T4).
AJCC: American Joint Committee on Cancer; CI: Confidence interval; OR: Odds ratio; SEMS: Self-expanding metal stent.
Table 6 Pathological features of patients with colorectal cancer according to decompression methods (transanal tube vs 18-mm stent vs 22-mm stent)
Characteristic1All cases (n = 102)Decompression methods
P value2,3
Transanal tube (n = 76)
18 mm stent (n = 11)
22 mm stent (n = 15)
Lymphatic invasion, n (%)0.055 (0.0060)
Absent11 (11)10 (13)1 (9.1)-
Minimal41 (40)33 (43)5 (45)3 (20)
Moderate32 (31)23 (30)4 (36)5 (33)
Severe18 (18)10 (13)1 (9.1)7 (47)
Venous invasion, n (%)< 0.0001 (0.0006)
Absent19 (19)17 (22)2 (18)-
Minimal45 (44)37 (49)3 (27)5 (33)
Moderate23 (23)19 (25)1 (9.1)3 (20)
Severe15 (15)3(4.0)5 (45)7 (47)
1Percentage indicates the proportion of patients with a specific clinical characteristic among all patients or in strata of decompression methods.
2We used the chi-square test to compare as categorical variables. We adjusted the two-sided α level to 0.05.
3We used the Mann-Whitney U test to compare as nonparametric continuous variables. We adjusted the two-sided α level to 0.05.