Use of the Bard Memotherm self-expanding metal stent in the palliation of colonic obstruction.
BACKGROUND
Self-expanding metal stents (SEMS) are a recognized means of palliating large bowel obstruction due to colonic neoplasia. The literature mainly relates to the use of modified esophageal stents (expanded diameter, 18-22 mm) in the colorectum. Stent migration has been a common complication and may be related to expanded stent diameter. This series reports our experience with the Memotherm Colorectal SEMS (expanded diameter, 25-30 mm).


METHODS
Prospective data were collected from February 1999 to September 2000. Sixteen patients (age range = 61-99 years) were considered for the Memotherm Colorectal SEMS. Stents were inserted radiologically under fluoroscopic control. Outcome was classified as a technical success (stent in correct position and expanded) and a clinical success (colon decompressed, symptoms relieved, and bowels working).


RESULTS
Thirteen cases (81%) underwent successful SEMS placement. These were technically and clinically successful. Two cases required insertion of two overlapping stents to traverse long strictures. Three unsuccessful cases were emergency presentations in which a guidewire could not be passed across the lesion. Two of these were due to benign strictures and the third to extrinsic compression by ovarian carcinoma.


CONCLUSIONS
In our experience, the Memotherm Colorectal SEMS was easy to use, was effective in the palliation of obstructing colorectal carcinoma, and appeared to reduce the risk of stent migration.
Clark
J S
JS
Eastbourne District General Hospital, Kings Drive, Eastbourne BN21 2UD, United Kingdom.
Buchanan
G N
GN
Khawaja
A R
AR
Rowe
P H
PH
Stoodley
B J
BJ
Saunders
M P
MP
Anderson
H J
HJ
D000368:Aged; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000150:complications; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D010166:Palliative Care; D011446:Prospective Studies; D011859:Radiography; D012810:Sigmoid Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D015607:Stents