BACKGROUND: Self-expandable metal stents (SEMS) can be used to relieve benign and malignant colorectal obstruction. AIMS: The aim of this study was to determine the outcomes of SEMS for malignant colorectal obstruction. METHODS: Retrospective review was done of patients who underwent endoscopic SEMS placement from 2001 to 2007. RESULTS: Forty-six patients (23 M), mean age 60 years (range 24-82) underwent endoscopic SEMS placement. Cancer types included: 28 colorectal, and 18 metastatic cancers. The locations of the obstruction were as follows: two in the ascending colon, one in the hepatic flexure, three in the transverse colon, two in the splenic flexure, two in the descending colon, 26 in the sigmoid colon, and ten in the rectum. In 39 of the 46 cases (84.8%), placement of a single SEMS was successful covering the entire strictures, but in seven cases, two of the stents were placed in tandem resulting in adequate overage of stricture. Technical success was achieved in all cases. Clinical success was achieved in 39 out of 46 cases (84.8%). Two perforations were detected immediately and day 5 after SEMS placement, resulting in one death and one emergent surgery. Mean follow-up was 126 days (range 2-1,210). Twenty-eight of the 46 patients (61%) died during the follow-up period with the median overall survival being 3.52 months (95% CI: 2.34-4.41 months). CONCLUSIONS: Placement of SEMS for the treatment of colorectal obstruction is feasible and safe. In our institution, where SEMS are primarily used to palliate terminal disease, technical and clinical success rates were high without significant morbidity and mortality. On long-term follow-up, patients died from their advanced disease with infrequent recurrent obstruction or stent-related complications.
BACKGROUND: Self-expandable metal stents (SEMS) can be used to relieve benign and malignant colorectal obstruction. AIMS: The aim of this study was to determine the outcomes of SEMS for malignant colorectal obstruction. METHODS: Retrospective review was done of patients who underwent endoscopic SEMS placement from 2001 to 2007. RESULTS: Forty-six patients (23 M), mean age 60 years (range 24-82) underwent endoscopic SEMS placement. Cancer types included: 28 colorectal, and 18 metastatic cancers. The locations of the obstruction were as follows: two in the ascending colon, one in the hepatic flexure, three in the transverse colon, two in the splenic flexure, two in the descending colon, 26 in the sigmoid colon, and ten in the rectum. In 39 of the 46 cases (84.8%), placement of a single SEMS was successful covering the entire strictures, but in seven cases, two of the stents were placed in tandem resulting in adequate overage of stricture. Technical success was achieved in all cases. Clinical success was achieved in 39 out of 46 cases (84.8%). Two perforations were detected immediately and day 5 after SEMS placement, resulting in one death and one emergent surgery. Mean follow-up was 126 days (range 2-1,210). Twenty-eight of the 46 patients (61%) died during the follow-up period with the median overall survival being 3.52 months (95% CI: 2.34-4.41 months). CONCLUSIONS: Placement of SEMS for the treatment of colorectal obstruction is feasible and safe. In our institution, where SEMS are primarily used to palliate terminal disease, technical and clinical success rates were high without significant morbidity and mortality. On long-term follow-up, patients died from their advanced disease with infrequent recurrent obstruction or stent-related complications.
Authors: Jesús García-Cano; Ferran González-Huix; Diego Juzgado; Francisco Igea; Manuel Pérez-Miranda; Leopoldo López-Rosés; Antonio Rodríguez; Pedro González-Carro; Luis Yuguero; Jorge Espinós; Julio Ducóns; Víctor Orive; Santiago Rodríguez Journal: Gastrointest Endosc Date: 2006-12 Impact factor: 9.427
Authors: Mehmet Abdussamet Bozkurt; Murat Gonenc; Selin Kapan; Ali Kocatasş; Baha Temizgönül; Halil Alis Journal: JSLS Date: 2014 Oct-Dec Impact factor: 2.172