Abstract
Background
In recent years, stent placement for malignant colorectal obstruction has become an accepted alternative to surgery. The purpose of this study was to evaluate the usefulness of self-expandable metallic stents (SEMS) as palliative management for patients with unresectable malignant colorectal obstruction.
Methods
Twelve patients with unresectable malignant colorectal obstruction were treated with SEMS as palliative therapy. The sites of obstruction were located in the rectum (n = 9), the descending colon (n = 1), and the transverse colon (n = 2). All procedures were performed with combined endoscopic and fluoroscopic guidance. We analyzed the technical and clinical success rates of stent placement and the complications associated with the procedure.
Results
The stents were successfully implanted and bowel obstruction was relieved in all cases; the technical and clinical success rates were 100%. Two complications occurred, including stent migration. There was no case requiring reintervention. All patients died of initial disease or another coexisting disease between 9 and 534 days (mean 133 ± 148 days) after stent placement. None of the patients with stent in position at death had clinical or radiologic signs of bowel obstruction.
Conclusions
SEMS placement in patients with malignant colorectal obstruction is technically feasible and safe, making it useful as a palliative treatment.
Similar content being viewed by others
References
Deans GT, Krukowski ZH, Irwin ST (1994) Malignant obstruction of the left colon. Br J Surg 81:1270–1276
Riedl S, Wiebelt H, Bergmann U, et al. (1995) Postoperative complications and fatalities in surgical therapy of colon carcinoma. Results of the German multicenter study by the Colorectal Carcinoma Study Group. Chirurg 66:597–606
Mulcahy HE, Skelly MM, Husain A, et al. (1996) Long-term outcome following curative surgery for malignant large bowel obstruction. Br J Surg 83:46–50
Nugent KP, Daniels P, Stewart B, et al. (1999) Quality of life in stoma patients. Dis Colon Rectum 42:1569–1574
Miyayama S, Matsui O, Kifune K, et al. (2000) Malignant colonic obstruction due to extrinsic tumor: palliative treatment with a self-expanding nitinol stent. AJR Am J Roentgenol 175:1631–1637
Camunez F, Echenagusia A, Simo G, et al. (2000) Malignant colorectal obstruction treated by means of self-expanding metallic stents: effectiveness before surgery and in palliation. Radiology 216:492–497
Mishima K, Sawada S, Tanigawa N, et al. (1999) Expandable metallic stent treatment for malignant colorectal strictures. Cardiovasc Intervent Radiol 22:155–158
Mainar A, Tejero E, Maynar M, et al. (1996) Colorectal obstruction: treatment with metallic stents. Radiology 198:761–764
Wong KS, Cheong DM, Wong D (2002) Treatment of acute malignant colorectal obstruction with self-expandable metallic stents. ANZ J Surg 72:385–358
Tack J, Gevers AM, Rutgeerts P (1998) Self-expandable metallic stents in the palliation of rectosigmoidal carcinoma: a follow-up study. Gastrointest Endosc 48:267–271
Coco C, Cogliandolo S, Riccioni ME, et al. (2000) Use of a self-expanding stent in the palliation of rectal cancer recurrences. A report of three cases. Surg Endosc 14:708–711
Wallis F, Campbell KL, Eremin O, et al. (1998) Self-expanding metal stents in the management of colorectal carcinoma–a preliminary report. Clin Radiol 53:251–254
Paul Diaz L, Pinto Pabon I, Fernandez Lobato R, et al. (1999) Palliative treatment of malignant colorectal strictures with metallic stents. Cardiovasc Intervent Radiol 22:29–36
Maetani I, Tada T, Ukita T, et al. (2004) Self-expandable metallic stent placement as palliative treatment of obstructed colorectal carcinoma. J Gastroenterol 39:334–348
Khot UP, Lang AW, Murali K, et al. (2002) Systematic review of the efficacy and safety of colorectal stents. Br J Surg 89:1096–1102
Sebastian S, Johnston S, Geoghegan T, et al. (2004) Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction. Am J Gastroenterol 99:2051–2057
Keymling M (2003) Colorectal stenting. Endoscopy 35:234–238
Baron TH, Dean PA, Yates MR 3rd, et al. (1998) Expandable metal stents for the treatment of colonic obstruction: techniques and outcomes. Gastrointest Endosc 47:277–286
Meisner S, Hensler M, Knop FK, et al. (2004) Self-expanding metal stents for colonic obstruction: experiences from 104 procedures in a single center. Dis Colon Rectum 47:444–450
Tominaga K, Yoshida M, Maetani I, et al. (2001) Expandable metal stent placement in the treatment of a malignant anastomotic stricture of the transverse colon. Gastrointest Endosc 53:524–527
Lopera JE, Ferral H, Wholey M, et al. (1997) Treatment of colonic obstructions with metallic stents: indications, technique, and complications. AJR Am J Roentgenol 169:1285–1290
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tsurumaru, D., Hidaka, H., Okada, S. et al. Self-expandable metallic stents as palliative treatment for malignant colorectal obstruction. Abdom Imaging 32, 619–623 (2007). https://doi.org/10.1007/s00261-006-9159-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-006-9159-z