Christian P Selinger1, Jayapal Ramesh, Derrick F Martin. 1. Department of Gastroenterology, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, Manchester, UK. Christian.selinger@web.de
Abstract
INTRODUCTION: Stent insertion plays an important part in the management of acute colonic obstruction. There are limited data on factors influencing short- and long-term success. AIMS AND METHODS: We investigated indications, technical and clinical success rates, complication rates and the factors influencing them. Patients were identified from our prospective colonic stent database (2000-2008). RESULTS: One hundred and four stents were attempted in 96 patients (technical success rate, 83.3%). Clinical short-term success was observed in 74 (77.1%) patients. Follow-up data available for 57 patients showed clinical long-term success in 77% (44/57). Multiple logistic regression analysis showed a significant decline in technical success over the study period (p = 0.041). Patients with colonic malignancy had significantly higher long-term success rates (81%), compared to those with extra-colonic malignancies (43%) (p = 0.049). Length of stent and site of obstruction were not significant factors. Early complications occurred in 10%, and late complications, in 26.3% of cases. CONCLUSION: Colonic stent insertion provides symptom relief in over 70% when used as a long-term solution. Complication rates are high, and a significant minority of patients requires re-intervention. Obstruction caused by extra-colonic malignancy is far less likely to be permanently palliated by a stent, in comparison to colonic malignancy.
INTRODUCTION: Stent insertion plays an important part in the management of acute colonic obstruction. There are limited data on factors influencing short- and long-term success. AIMS AND METHODS: We investigated indications, technical and clinical success rates, complication rates and the factors influencing them. Patients were identified from our prospective colonic stent database (2000-2008). RESULTS: One hundred and four stents were attempted in 96 patients (technical success rate, 83.3%). Clinical short-term success was observed in 74 (77.1%) patients. Follow-up data available for 57 patients showed clinical long-term success in 77% (44/57). Multiple logistic regression analysis showed a significant decline in technical success over the study period (p = 0.041). Patients with colonic malignancy had significantly higher long-term success rates (81%), compared to those with extra-colonic malignancies (43%) (p = 0.049). Length of stent and site of obstruction were not significant factors. Early complications occurred in 10%, and late complications, in 26.3% of cases. CONCLUSION: Colonic stent insertion provides symptom relief in over 70% when used as a long-term solution. Complication rates are high, and a significant minority of patients requires re-intervention. Obstruction caused by extra-colonic malignancy is far less likely to be permanently palliated by a stent, in comparison to colonic malignancy.
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