Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 24 (2), 400-6

Effectiveness of Stent Placement for Palliative Treatment in Malignant Colorectal Obstruction and Predictive Factors for Stent Occlusion

Affiliations

Effectiveness of Stent Placement for Palliative Treatment in Malignant Colorectal Obstruction and Predictive Factors for Stent Occlusion

Jung Pil Suh et al. Surg Endosc.

Abstract

Background: Self-expandable metallic stent (SEMS) for malignant colorectal obstruction is widely used in palliative treatment and as an alternative to surgery. The aims of this study are to evaluate the effectiveness of stent placement for palliative treatment and to identify the predictive factors associated with stent occlusion.

Methods: A retrospective analysis was performed in 55 patients who had undergone placement of an uncovered SEMS from February 2004 to April 2007 for palliative treatment of malignant colorectal obstruction with metastatic or locally advanced cancer that was surgically unresectable. We analyzed the technical and clinical outcomes of stent placement, complications related to the procedure, stent patency rate, and predictive factors associated with stent occlusion.

Results: The causes of colorectal obstruction before stent placement were primary colorectal cancer in 42 patients and noncolorectal extrinsic cancer in 13 patients. The initial technical success rate was 98.2%, and the clinical success rate was 94.4%. Complications occurred in 17 patients (30.9%). These included stent occlusion (n = 8), migration (n = 6), bowel perforation (n = 1), stent distortion (n = 1), and fistula formation (n = 1). The mean and median stent patency periods were 184 days [95% confidence interval (CI), 137-230 days] and 141 days (95% CI, 69-213 days), respectively. The degree of expansion 48 h after stent placement was significantly better in the nonocclusion group than in the stent occlusion group. In the multivariate Cox proportional hazard model, insufficient stent expansion (<70%) 48 h after stent placement was significantly associated with an increase in stent occlusion during the follow-up period (odds ratio, 12.55; p = 0.002).

Conclusions: Uncovered SEMS placement is an effective palliative treatment for malignant colorectal obstruction. The degree of stent expansion 48 h after stent placement is significantly associated with the maintenance of stent patency and is a predictive factor for stent occlusion.

Similar articles

See all similar articles

Cited by 15 PubMed Central articles

See all "Cited by" articles

References

    1. Br J Surg. 2002 Sep;89(9):1096-102 - PubMed
    1. Cardiovasc Intervent Radiol. 1999 Jan;22(1):29-36 - PubMed
    1. Surg Endosc. 2006 Jul;20(7):1072-6 - PubMed
    1. Gynecol Oncol. 2008 Mar;108(3):482-5 - PubMed
    1. Surg Endosc. 2007 Jul;21(7):1101-3 - PubMed

Publication types

MeSH terms

LinkOut - more resources

Feedback