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Surgical Endoscopy

, Volume 27, Issue 9, pp 3288–3296 | Cite as

Clinical outcomes following secondary self-expandable metal stent (SEMS) insertion due to previous stent migration in malignant colorectal obstruction

  • A. Ra Choi
  • Jin Young Yoon
  • Hyun Jung Lee
  • Hui Won Jang
  • Soo Jung Park
  • Sung Pil Hong
  • Tae Il Kim
  • Won Ho Kim
  • Jae Hee CheonEmail author
Article
  • 195 Downloads

Abstract

Background

There has been no research on the clinical outcomes of secondary self-expandable metal stent (SEMS) placement after initial stent migration. Therefore, this study aimed to assess the clinical outcomes of secondary SEMS placement after initial stent migration compared to the outcomes of secondary SEMS placement done for reasons other than migration and identify factors predictive of long-term outcomes.

Methods

Between January 2005 and February 2011, a total of 422 patients underwent SEMS insertion for malignant colorectal obstruction at Severance Hospital. Of these, there were 98 cases of secondary SEMS placement, 38 of which were due to previous stent migration. We compared the clinical outcomes of secondary SEMS between stent migration and nonmigration groups. We also sought to identify risk factors for long-term outcomes of secondary SEMS after initial stent migration.

Results

The baseline clinical characteristics were similar between the two groups. The technical and clinical success rates of secondary SEMS insertion in the migration and nonmigration groups were 94.7 % and 83.3 % (p = 0.09) and 73.7 % and 53.3 % (p = 0.122), respectively. In the migration group, sustained clinical success after secondary SEMS was associated with the absence of complications after insertion of the first stent (p < 0.001) and a longer time interval (more than 100 days) between the first and second stent insertion (p = 0.011).

Conclusions

Our data showed that secondary colorectal SEMS after stent migration is safe and effective. Moreover, the sustained clinical success of the secondary stent following migration was dependent on the outcomes of the first stent.

Keywords

Self-expandable metal stent Stent migration Colorectal obstruction Outcome 

Notes

Disclosures

Drs. A Ra Choi, Jin Young Yoon, Hyun Jung Lee, Hui Won Jang, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim, and Jae Hee Cheon have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • A. Ra Choi
    • 1
  • Jin Young Yoon
    • 1
  • Hyun Jung Lee
    • 1
  • Hui Won Jang
    • 1
  • Soo Jung Park
    • 1
  • Sung Pil Hong
    • 1
  • Tae Il Kim
    • 1
  • Won Ho Kim
    • 1
  • Jae Hee Cheon
    • 1
    Email author
  1. 1.Department of Internal MedicineYonsei University College of MedicineSeoulSouth Korea

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