Factors associated with the long-term outcome of a self-expandable colon stent used for palliation of malignant colorectal obstruction

Jung, Min Kyu; Park, Soo Young; Jeon, Seong Woo; Cho, Chang Min; Tak, Won Young; Kweon, Young Oh; Kim, Sung Kook; Choi, Yong Hwan; Kim, Gab Chul; Ryeom, Hun Kyu

doi:10.1007/s00464-009-0604-2

Cited by 64 publications

(48 citation statements)

References 20 publications

(43 reference statements)

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“…22 In the present series, surgical resected patients stayed in hospital a mean of 14.5 days as opposed to with 8.8 days when managed by stenting. However, it should also be taken into consideration that with a re-stenting rate of 18.3 %, patients managed by stenting have a cumulative hospital stay due to repeated treatment that surgical patients do not face and that can interfere with chemotherapy already started.…”

Section: Short Term Resultsmentioning

confidence: 62%

“…22 The study we report does not analyze quality of life but neither supports the tight association between palliative surgery and colostomy construction. Of the 17 patients finally operated on, only 7 colostomies were constructed: four lateral colostomies and 3…”

Section: Short Term Resultsmentioning

confidence: 69%

“…As a palliative treatment, success rates of up to 96.4% have been reported with early and late mayor morbidity rates of 24.4 % (including perforation, migration, bleeding) and 8.9 % reobstruction rate. 22 It has also recently been reported how a prospective randomized study, allocating stage IV patients under chemotherapy at risk of obstruction for either stenting or surgery has been closed due to a high incidence of severe complications in the stent group. 13 In the present series, we report a successful insertion rate of 91.8 % with 11.1% morbidity rate.…”

Section: Short Term Resultsmentioning

confidence: 99%

“…21 Other groups have tried to stent palliative patients as a definitive treatment of obstruction. 22 This has been so far the idea of our group hoping to spare morbidity and mortality to patients to whom curative treatment is no longer possible.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Outcomes in the management of obstructive unresectable stage IV colorectal cancer

Frago

Kreisler

Biondo

et al. 2010

European Journal of Surgical Oncology (EJSO)

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Section: Short Term Resultsmentioning

confidence: 62%

Section: Short Term Resultsmentioning

confidence: 69%

Section: Short Term Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes in the management of obstructive unresectable stage IV colorectal cancer

Frago

Kreisler

Biondo

et al. 2010

European Journal of Surgical Oncology (EJSO)

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“…Few studies followed the majority of patients until death after stent placement, and there is a small amount of long-term clinical outcomes data with conflicting results. Recent studies reported that a single palliative SEMS implantation is associated with long-term (until death) success rates up to 80%, although the complication rate is nearly 25% (6,7,12,13). These results, however, conflict with other studies reporting short-and longterm clinical failure in more than 50% of patients, along with a high number of severe complications (4,5).…”

Section: Introductionmentioning

confidence: 93%

Sustained relief of obstructive symptoms for the remaining life of patients following placement of an expandable metal stent for malignant colorectal obstruction

Liberato

Marques

et al. 2012

Rev. esp. enferm. dig.

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Background: self-expanding metal stents are currently being used as a definitive palliative treatment for malignant colorectal obstruction in patients with incurable disease. Few studies have followed large numbers of patients from stent placement until death, and those few have reported conflicting results in the long-term clinical outcome data.Aims: this study evaluated the clinical effectiveness of stent placement for malignant colorectal obstruction throughout the patients' lives and related factors affecting stent patency, clinical success and complications.Methods: this was a multicentre, retrospective study of 89 consecutive patients who had undergone attempted expandable stent placement for symptomatic malignant colorectal obstruction during a 10-year period. Data were collected to analyse the sustained relief of obstructive symptoms throughout the patients' lives, as well as the technical success, immediate clinical success, stent patency, complications, reinterventions, survival, prognostic factors associated with stent patency and long-term clinical efficacy and risk factors for complications.Results: technical and immediate clinical success were achieved in 95.5% and 91.0% of patients, respectively. A total of 68 out of 89 patients (76.4%) maintained relief of obstruction from stent implantation until death without reintervention. Twenty patients (22.5%) had complications including perforation (n = 4; 4.5%), stent obstruction (n = 8; 9.0%), migration (n = 5; 5.6%) and haemorrhage (n = 3; 3.4%). Stent-related mortality was seen in 1 patient (1.1%). The estimated median survival and estimated mean stent patency were 87.0 and 322.7 days, respectively. In total, 12 of the initial 89 patients (13.5%) needed a colostomy for long-term relief of the obstructive symptoms. Univariate and multivariate analysis detected no significant prognostic factors associated with stent patency, longterm clinical efficacy and risk factors for complications; however, the multivariate logistic model revealed a non-significant trend by which the use of chemotherapy was a risk factor for migration (OR = 11.89; p = 0.06).Conclusions: for palliation of incurable malignant colorectal obstruction, expandable stents can provide sustained relief of obstruction in approximately 75% of patients. The procedure is associated with acceptable morbidity, need for reintervention and minimal mortality.Key words: Self-expanding metal stent. Colorectal obstruction. Endoscopic definitive palliation. INTRODUCTIONColorectal cancer is one of the most common malignancies worldwide (1). In patients with colorectal cancer, obstruction occurs in 15 to 20% (2). Most of these patients have advanced disease and are often elderly, with significant comorbidities (2-4). In this group of patients, curative resection is not frequently feasible (4,5). Therefore, palliation is the primary aim in these patients (3,6,7). Emergency surgical decompression is associated with high mortality and morbidity figures (8,9). In addition, surgery often involves creation of a...

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Training in the Use of Fluoroscopy for Gastrointestinal Endoscopy

Adler

Lanke

2022

Successful Training in Gastrointestinal Endoscopy

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Factors associated with the long-term outcome of a self-expandable colon stent used for palliation of malignant colorectal obstruction

Abstract: Patients with bowel obstruction involving a short segment and those with a distal obstruction had better stent outcomes.

Cited by 64 publications

References 20 publications

Outcomes in the management of obstructive unresectable stage IV colorectal cancer

Outcomes in the management of obstructive unresectable stage IV colorectal cancer

Sustained relief of obstructive symptoms for the remaining life of patients following placement of an expandable metal stent for malignant colorectal obstruction

Training in the Use of Fluoroscopy for Gastrointestinal Endoscopy

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