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Factors associated with the long-term outcome of a self-expandable colon stent used for palliation of malignant colorectal obstruction

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Abstract

Background

The placement of self-expanding metal stents (SEMS) is a safe and effective definitive procedure for the palliation of malignant colorectal obstruction. In this study, the clinical outcomes, including the technical and clinical success rates, and the risk factors associated with the long-term outcomes of palliative SEMS were evaluated.

Methods

From February 2002 to April 2008, 39 patients (18 men and 21 women) with malignant colorectal obstruction underwent placement of uncovered or covered stents under fluoroscopic or endoscopic guidance. The mean age of the patients was 64.5 ± 14.6 years (range, 37–96 years).

Results

The technical success rate was 100% (39/39), and the clinical success rate was 87.2% (34/39). Five cases had failed relief of the obstruction due to the development of migration in two patients, two malfunctions, and one perforation. Four patients experienced late complications: migration managed with a palliative colostomy in two patients, tumor ingrowth managed successfully with a second stent in one patient, perforation with an intraabdominal abscess at the upper margin of the stent 4 months after stenting in one patient. The location of the obstruction and the length of the stent were significant factors associated with a good outcome. Shorter stents (<10 cm) had better outcomes than longer stents (≥10 cm; p = 0.008), and patients with a distal colorectal obstruction had better outcomes than those with a proximal colorectal obstruction (p = 0.015).

Conclusion

Patients with bowel obstruction involving a short segment and those with a distal obstruction had better stent outcomes.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, 50, Samduk-Dong 2 Ga, Chung-Gu, Daegu, 700-721, South Korea

    Min Kyu Jung, Soo Young Park, Seong Woo Jeon, Chang Min Cho, Won Young Tak, Young Oh Kweon, Sung Kook Kim & Yong Hwan Choi

  2. Department of Radiology, Kyungpook National University Hospital, 50, Samduk-Dong 2 Ga, Chung-Gu, Daegu, 700-721, South Korea

    Gab Chul Kim & Hun Kyu Ryeom

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  1. Min Kyu Jung
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  2. Soo Young Park
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  4. Chang Min Cho
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  5. Won Young Tak
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  9. Gab Chul Kim
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  10. Hun Kyu Ryeom
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Correspondence to Seong Woo Jeon.

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Jung, M.K., Park, S.Y., Jeon, S.W. et al. Factors associated with the long-term outcome of a self-expandable colon stent used for palliation of malignant colorectal obstruction. Surg Endosc 24, 525–530 (2010). https://doi.org/10.1007/s00464-009-0604-2

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  • DOI: https://doi.org/10.1007/s00464-009-0604-2

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