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What is the necessity of endoscopist for successful endoscopic stenting in patients with malignant colorectal obstruction?

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aim

Recently, self-expandable metal stents (SEMSs) have been widely used as an initial therapy for relieving malignant colorectal obstructions. However, several factors, including the endoscopist’s experience, affect the clinical outcome of SEMSs. The aim of this study was to define the adequate level of experience necessary to perform endoscopic stenting effectively and safely and to identify technical factors for successful stenting.

Methods

Between March 2009 and June 2012, 160 patients underwent SEMS placement for malignant colorectal obstruction with the intent of palliation or as a bridge to surgery by a single endoscopist who experienced colonoscopy and endoscopic retrograde cholangiopancreatography.

Results

The overall technical and clinical success rates were 86.9 and 86.4 %, respectively, and 18 complications (11.3 %) were observed. There were no differences in any of the clinical outcomes between the consecutive blocks; however, the procedure time decreased significantly after the first 30 procedures (17.4, 16.9, 13.5, and 12.8 min; P = 0.044). American Society of Anesthesiologists (ASA) class, history of a previous operation, proximal colon obstruction, obstruction caused by an extracolonic malignancy, and palliative SEMS placement were associated with technical failure.

Conclusions

An endoscopist who experiences a colonoscopy and fluoroscopy performs SEMS placement successfully regardless of the level of experience. After the first 30 procedures, a SEMS insertion could be safely and effectively performed with short procedure time in patients with malignant colorectal obstruction.

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Conflict of interest

The authors have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yensei-ro, Seodaemun-gu, Seoul, 120-752, South Korea

    Hyun Jung Lee, Soo Jung Park, Jae Hee Cheon, Tae Il Kim, Won Ho Kim & Sung Pil Hong

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  1. Hyun Jung Lee
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  2. Soo Jung Park
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  3. Jae Hee Cheon
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  4. Tae Il Kim
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  5. Won Ho Kim
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  6. Sung Pil Hong
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Correspondence to Sung Pil Hong.

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Lee, H.J., Park, S.J., Cheon, J.H. et al. What is the necessity of endoscopist for successful endoscopic stenting in patients with malignant colorectal obstruction?. Int J Colorectal Dis 30, 119–125 (2015). https://doi.org/10.1007/s00384-014-2060-2

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  • DOI: https://doi.org/10.1007/s00384-014-2060-2

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