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Outcome of endoscopic self-expandable metal stents in acute malignant colorectal obstruction at a tertiary center
- Source :
- Revista Espanola de Enfermedades Digestivas, Vol 107, Iss 9, Pp 534-538
- Publisher :
- Aran Ediciones.
-
Abstract
- Background: Malignant colorectal obstruction (MCRO) by advanced colonic cancer occurs in 8-13% of colonic cancer patients. Emergent surgery carries a high mortality and morbidity risk. Endoscopic self-expanding metal stents (SEMS) may be used in acute MCRO. Aim: Evaluate clinical outcome of SEMS in acute MCRO and efficacy of SEMS placement considering fluoroscopy guidance. Methods: Retrospective study of patients with acute MCRO that placed SEMS in a 3 years period. Results: SEMS were placed in 47 patients, followed-up for a median time of 150 days. The intent of stenting was bridge to definitive surgery in 40% of the patients (n = 19) and palliation in the remaining 60% (n = 28). The location of the tumor did not influence the presence of lymph node involvement (p = 0.764) nor metastasis (p = 0.885). Mortality rate at year 1 was 61%. Survival was significantly higher in patients submitted later to combination therapy compared to chemotherapy, surgery or symptomatic treatment (p < 0.001). Fluoroscopy was used in 57% of the procedures. Clinical success was 79%. A second SEMS was needed during the procedure in 6% of the patients. Rate of early and late complications was 11% and 5%, respectively. Fluoroscopy guidance did not influence the occurrence of immediate (p = 0.385), early (p = 0.950) or late complications (p = 0.057). Thirty-three percent of patients underwent surgery at a later stage, with neo-adjuvant therapy in 18%. Conclusions: SEMS provide a relative safe and successful treatment in a palliative or bridge-to-surgery indication. No significant differences were found in SEMS placement success, early complications or late complications considering fluoroscopy guidance.
Details
- Language :
- English, Spanish; Castilian
- ISSN :
- 11300108
- Volume :
- 107
- Issue :
- 9
- Database :
- Directory of Open Access Journals
- Journal :
- Revista Espanola de Enfermedades Digestivas
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.430a4622b804120a1c5b22a33d774e2
- Document Type :
- article