Palliative Self-expanding Metal Stents in the Treatment of Malignant Colorectal Obstruction

Jeong, Ji Bong; Lee, Kook Lae; Kwon, Soon Beom; Kim, Joon Suk; Lee, Jae Kyung; Kim, Won; Jung, Yong Jin; Kim, Ji Won; Kim, Byeong Gwan

Abstract

BACKGROUND/AIMS
This study was designed to evaluate the outcomes of self-expanding metal stents (SEMS) as palliative treatment for malignant obstruction of the colon and rectum.
METHODS
From January 2003 to September 2009, 28 patients (12 men and 16 women) with malignant colorectal obstruction received placement of uncovered or covered stents for palliative purposes under endoscopic or fluoroscopic guidance. The rates of technical success, clinical success, and the complications associated with stent insertion, patient survival, and long-term stent patency were evaluated.
RESULTS
The technical and clinical success rates were 100% (28/28) and 89.3% (25/28), respectively. Among the 25 patients with technical and clinical success, seven patients (28%) experienced complications: A case of perforation (n=1) was managed by surgical intervention, cases of tumor ingrowth (n=4), tumor ingrowth and overgrowth (n=1), and tumor overgrowth (n=1) were managed successfully with an additional stent. The median survival duration was 128.0+/-54.8 days. The median stent patency duration was 93.0+/-29.1 days, and the patency rates at 30, 90, and 180 days were 92%, 52%, and 25%, respectively.
CONCLUSIONS
The placement of a self-expanding metal stent was safe and effective palliative treatment for malignant colorectal obstruction. Stent-associated complications can be managed with the placement of additional stents in the majority of the patients and long-term stent patency is favorable.