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Predictors of outcome for endoscopic colorectal stenting: a decade experience

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Endoscopic stenting is used with increasing frequency to treat colorectal conditions. Little is known about what influences outcome. This study aimed to determine the impact of various factors on the short- and long-term results of colorectal stenting.

Methods

A retrospective review was conducted of all endoscopic stenting procedures performed by a colorectal surgeon at a tertiary referral institution between 2003 and 2013. Main outcome measures included technical success, clinical success, complications, and predictors of outcome.

Results

Of the stent procedures, 183 were performed in 165 patients. The majority of patients (90 %) presented with a malignant obstruction (intrinsic colonic vs. extrinsic non-colonic). Carcinomatosis was present in 22 % of patients with malignancy, and it was associated with lower technical success compared to non-carcinomatosis (adjusted odds ratio [AOR] 0.2 [95 % confidence interval (CI) 0.1–0.8]; p = 0.021). Colonic malignancy was associated with higher clinical success compared to non-colonic malignancy (AOR 3.8 [95 % CI 1.4–10.3]; p = 0.009). Carcinomatosis increased the risk of complications compared to non-carcinomatosis (AOR 3.2 [95 % CI 1.0–10.0]; p = 0.049). The risk of complication was higher when a stent was deployed in the rectum compared to the colon (AOR 4.1 [95 % CI 1.5–11.7]; p = 0.008). The use of a covered stent was associated with higher complication rate compared to a non-covered stent (AOR 13.6 [95 % CI 2.6–71.2]; p = 0.002). Balloon dilation was associated with an increased risk of complications (AOR 4.6 [95 % CI 1.3–16.2]; p = 0.017).

Conclusions

Carcinomatosis was associated with lower technical success rate. Clinical success was higher in patients with a primary colonic malignancy. The use of a covered stent, balloon dilation of stricture, lesions in the rectum, and carcinomatosis were associated with higher risk for complications.

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Authors and Affiliations

  1. Cleveland Clinic Abu Dhabi, Digestive Disease Institute, Al-Maryah Island, P.O. Box 112412, Abu Dhabi, UAE

    Maher A. Abbas

  2. Cleveland Clinic, Digestive Disease Institute, Cleveland, OH, USA

    Maher A. Abbas & Mohammad A. Abbass

  3. University of California, San Diego, CA, USA

    Greg Kharabadze

  4. Kaiser Permanente, Los Angeles, CA, USA

    Ethan M. Ross

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  1. Maher A. Abbas
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  2. Greg Kharabadze
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  4. Mohammad A. Abbass
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Correspondence to Maher A. Abbas.

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Additional information

Delivered as a podium presentation at the American Society of Colon and Rectal Surgeons Annual Meeting, Boston, Massachusetts, May 30–June 3, 2015

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Abbas, M.A., Kharabadze, G., Ross, E.M. et al. Predictors of outcome for endoscopic colorectal stenting: a decade experience. Int J Colorectal Dis 32, 375–382 (2017). https://doi.org/10.1007/s00384-016-2696-1

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