Gut Liver.  2012 Jul;6(3):328-333.

The Learning Curve for Colorectal Stent Insertion for the Treatment of Malignant Colorectal Obstruction

• Lee JH
• Yoon JY
• Park SJ
• Hong SP
• Kim TI
• Kim WH
• Cheon JH

Abstract

BACKGROUND/AIMS
We aimed to assess the effectiveness of self-expanding metal stent (SEMS) insertion by evaluating the learning curve in relation to the experience of an endoscopist.
METHODS
We retrospectively analyzed the outcomes of 120 SEMS insertion procedures performed by one endoscopist in patients with malignant colorectal obstruction. We compared the technical and clinical success rates, complication rates, and duration of the procedures by quartiles.
RESULTS
The mean age of the patients (76 men and 44 women) was 64.6 years. The overall technical success rate was 95.0% (114/120), and the clinical success rate was 90.0% (108/120). The median procedure duration was 16.2 minutes (range, 3.4 to 96.5 minutes). From the first to the last quartile, the technical success rates were 90.0%, 96.7%, 96.7%, and 96.7% (p=0.263), and the clinical success rates were 90.0%, 90.0%, 96.7%, and 83.3% (p=0.588), respectively. Procedure-related complications were observed in 28 patients (23.3%). The complication rates for SEMS insertion when patients were divided by quartiles were 26.7%, 23.3%, 10.0%, and 33.3% (p=0.184), respectively. Moreover, the number of stents per procedure was 1.13, 1.03, 1.00, and 1.00 (p=0.029), respectively. The median duration of SEMS insertion decreased significantly, 20.9 to 14.8 minutes after the first 30 procedures (p=0.005).
CONCLUSIONS
An experienced endoscopist was able to perform the SEMS insertion procedure easily and effectively after performing 30 SEMS insertions.

Keyword

Learning curve; Colorectal stents; Self-expanding metallic stents; Malignant colorectal obstruction; Colorectal neoplasms

MeSH Terms

Colorectal Neoplasms
Humans
Learning
Learning Curve
Male
Retrospective Studies
Stents