BACKGROUND AND AIM: Recently, self-expandable metal stents (SEMSs) have been widely used as an initial therapy for relieving malignant colorectal obstructions. However, several factors, including the endoscopist's experience, affect the clinical outcome of SEMSs. The aim of this study was to define the adequate level of experience necessary to perform endoscopic stenting effectively and safely and to identify technical factors for successful stenting. METHODS: Between March 2009 and June 2012, 160 patients underwent SEMS placement for malignant colorectal obstruction with the intent of palliation or as a bridge to surgery by a single endoscopist who experienced colonoscopy and endoscopic retrograde cholangiopancreatography. RESULTS: The overall technical and clinical success rates were 86.9 and 86.4%, respectively, and 18 complications (11.3%) were observed. There were no differences in any of the clinical outcomes between the consecutive blocks; however, the procedure time decreased significantly after the first 30 procedures (17.4, 16.9, 13.5, and 12.8 min; P = 0.044). American Society of Anesthesiologists (ASA) class, history of a previous operation, proximal colon obstruction, obstruction caused by an extracolonic malignancy, and palliative SEMS placement were associated with technical failure. CONCLUSIONS: An endoscopist who experiences a colonoscopy and fluoroscopy performs SEMS placement successfully regardless of the level of experience. After the first 30 procedures, a SEMS insertion could be safely and effectively performed with short procedure time in patients with malignant colorectal obstruction.
BACKGROUND AND AIM: Recently, self-expandable metal stents (SEMSs) have been widely used as an initial therapy for relieving malignant colorectal obstructions. However, several factors, including the endoscopist's experience, affect the clinical outcome of SEMSs. The aim of this study was to define the adequate level of experience necessary to perform endoscopic stenting effectively and safely and to identify technical factors for successful stenting. METHODS: Between March 2009 and June 2012, 160 patients underwent SEMS placement for malignant colorectal obstruction with the intent of palliation or as a bridge to surgery by a single endoscopist who experienced colonoscopy and endoscopic retrograde cholangiopancreatography. RESULTS: The overall technical and clinical success rates were 86.9 and 86.4%, respectively, and 18 complications (11.3%) were observed. There were no differences in any of the clinical outcomes between the consecutive blocks; however, the procedure time decreased significantly after the first 30 procedures (17.4, 16.9, 13.5, and 12.8 min; P = 0.044). American Society of Anesthesiologists (ASA) class, history of a previous operation, proximal colon obstruction, obstruction caused by an extracolonic malignancy, and palliative SEMS placement were associated with technical failure. CONCLUSIONS: An endoscopist who experiences a colonoscopy and fluoroscopy performs SEMS placement successfully regardless of the level of experience. After the first 30 procedures, a SEMS insertion could be safely and effectively performed with short procedure time in patients with malignant colorectal obstruction.
Authors: Bo Kyung Kim; Sung Pil Hong; Hyun Mi Heo; Jin Young Kim; Hyuk Hur; Kang Young Lee; Jae Hee Cheon; Tae Il Kim; Won Ho Kim Journal: Gastrointest Endosc Date: 2011-12-09 Impact factor: 9.427
Authors: Hyun Jung Lee; Sung Pil Hong; Jae Hee Cheon; Tae Il Kim; Byung So Min; Nam Kyu Kim; Won Ho Kim Journal: Gastrointest Endosc Date: 2011-01-22 Impact factor: 9.427
Authors: Jorge Manuel Canena; Manuel Liberato; Inês Marques; Catarina Isabel Rodrigues; Ana Catarina Lagos; Sara Daniela Patrocínio; Miguel J Tomé; Eduardo Nuno Cpires; Carlos Romão; António Pereira Coutinho; Pedro Miguel Veiga; Beatriz C Neves; João Reis Deus; Hélder Daniel Além; José Augusto Gonçalves Journal: Rev Esp Enferm Dig Date: 2012-08 Impact factor: 2.086
Authors: Alessandro Repici; Douglas G Adler; Christopher M Gibbs; Alberto Malesci; Paoletta Preatoni; Todd H Baron Journal: Gastrointest Endosc Date: 2007-11 Impact factor: 9.427