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International Journal of Colorectal Disease

, Volume 25, Issue 6, pp 747–750 | Cite as

Efficacy and safety of colonic stenting for malignant disease in the elderly

  • Fergal Donnellan
  • Garret Cullen
  • Daniel Cagney
  • Phil O’Halloran
  • Gavin C. Harewood
  • Frank E. Murray
  • Stephen E. Patchett
Original Article

Abstract

Background

Self-expandable metal stents (SEMS) are an accepted palliation for malignant colorectal obstruction. Outcomes of stent insertion solely in older patients are unknown.

Objective

To compare outcomes of SEMS insertion for malignant colorectal disease, in older versus younger patients.

Methods

Forty-three patients were retrospectively identified as having undergone SEMS insertion for obstructing colorectal cancer. Of these, 24 were ≥ 70 years of age (older patient group) and 19 were <70 years of age (younger patient group).

Results

There was no significant difference in successful SEMS insertion between the groups (88% in older versus 100% in younger patients, p > 0.05). Furthermore, the complication rate was similar in both groups (12.5% versus 26%, p > 0.10). There was no difference in median survival (113 days versus 135 days, p > 0.09).

Conclusion

Colorectal stenting for malignant disease in older patients is both safe and effective with comparative success and complication rates to a younger population.

Keywords

Colon cancer Endoscopic stenting Elderly 

References

  1. 1.
    Stipa F, Pigazzi A, Bascone B, Cimitan A, Villotti G, Burza A, Vitale A (2008) Management of obstructive colorectal cancer with endoscopic stenting followed by single-stage surgery: open or laparoscopic resection? Surg Endosc 22(6):1477–1481CrossRefPubMedGoogle Scholar
  2. 2.
    Ng KC, Law WL, Lee YM, Choi HK, Seto CL, Ho JW (2006) Self-expanding metallic stent as a bridge to surgery versus emergency resection for obstructing left-sided colorectal cancer: a case-matched study. J Gastrointest Surg 10(6):798–803CrossRefPubMedGoogle Scholar
  3. 3.
    Saida Y, Sumiyama Y, Nagao J, Uramatsu M (2003) Long-term prognosis of preoperative "bridge to surgery" expandable metallic stent insertion for obstructive colorectal cancer: comparison with emergency operation. Dis Colon Rectum 46:S44–S49PubMedGoogle Scholar
  4. 4.
    Alcantara M, Serra X, Bombardó J, Falcó J, Perandreu J, Ayguavives I, Mora L, Hernando R, Navarro S (2007) Colorectal stenting as an effective therapy for preoperative and palliative treatment of large bowel obstruction: 9 years' experience. Tech Coloproctol 11(4):316–322CrossRefPubMedGoogle Scholar
  5. 5.
    Mucci-Hennekinne S, Kervegant AG, Regenet N, Beaulieu A, Barbieux JP, Dehni N, Casa C, Arnaud JP (2007) Management of acute malignant large-bowel obstruction with self-expanding metal stent. Surg Endosc 21(7):1101–1103CrossRefPubMedGoogle Scholar
  6. 6.
    Sebastian S, Johnston S, Geoghegan T, Torreggiani W, Buckley M (2004) Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction. Am J Gastroenterol 99:2051–2057CrossRefPubMedGoogle Scholar
  7. 7.
    Dohmoto M (1991) New method-endoscopic implantation of rectal stent in paliative treatment of malignant stenosis. Endoscopia Digestiva 3:1507–1512Google Scholar
  8. 8.
    Tilney HS, Lovegrove RE, Purkayastha S, Sains PS, Weston-Petrides GK, Darzi AW, Tekkis PP, Heriot AG (2007) Comparison of colonic stenting and open surgery for malignant large bowel obstruction. Surg Endosc 21:225–233CrossRefPubMedGoogle Scholar
  9. 9.
    Health in Ireland, Key Trends 2007. www.dohc.ie/statistics
  10. 10.
    Baraza W, Lee F, Brown S, Hurlstone DP (2008) Combination endo-radiological colorectal stenting: a prospective 5-year clinical evaluation. Colorectal Dis 10(9):901–906PubMedGoogle Scholar
  11. 11.
    Kim H, Kim SH, Choi SY, Lee KH, Won JY, Lee do Y, Lee JT (2008) Fluoroscopically guided placement of self-expandable metallic stents and stent-grafts in the treatment of acute malignant colorectal obstruction. J Vasc Interv Radiol 19(12):1709–1716CrossRefPubMedGoogle Scholar
  12. 12.
    Khot UP, Lang AW, Murali K, Parker MC (2002) Systematic review of the efficacy and safety of colorectal stents. Br J Surg 89(9):1096–1102CrossRefPubMedGoogle Scholar
  13. 13.
    Small AJ, Baron TH (2008) Comparison of Wallstent and Ultraflex stents for palliation of malignant left-sided colon obstruction: a retrospective, case-matched analysis. Gastrointest Endosc 67(3):478–488CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Fergal Donnellan
    • 1
  • Garret Cullen
    • 1
  • Daniel Cagney
    • 1
  • Phil O’Halloran
    • 1
  • Gavin C. Harewood
    • 1
  • Frank E. Murray
    • 1
  • Stephen E. Patchett
    • 1
  1. 1.Department of GastroenterologyBeaumont HospitalDublinIreland

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