Colorectal stenting for colonic obstruction: the indications, complications, effectiveness and outcome--5 year review.
BACKGROUND
Currently self-expanding metallic stents are being used for palliation and acute decompression of colonic obstruction. The aim of this study is to review our experience of using these metallic stents over a 5-year period.


METHODS
Case records of 102 patients who had colorectal stenting between 1998 and 2004 were reviewed retrospectively. The indications for colorectal stenting, efficacy of the procedure in relieving the obstruction, complications and clinical outcome were analysed.


RESULTS
Ninety-nine patients had malignant disease and in three patients a benign cause of obstruction was demonstrated. All procedures were performed during normal working hours. Stenting was technically successful in 87 patients (85%). A single stent was placed in 80 patients. Seven patients required two stents. Of the successful cases, 67 had stents placed by fluoroscopy alone and 20 by a combined fluoroscopy/endoscopy procedure. Four percent had early complications (within 30 days) which included four perforations. There were late complications (over 30 days) in 9% which included five stent migrations, two blocked stents and one colovesical fistula. Ninety percent (n=76) of the successful patients needed no further radiological or surgical intervention later. Survival ranged from 14 days to 2 years.


CONCLUSIONS
Colorectal stenting when technically successful is an effective procedure for both preoperative and palliative decompression of colonic obstruction.
Athreya
S
S
Department of Radiology, Gartnavel General Hospital, Glasgow, UK. harshavbs@yahoo.com
Moss
J
J
Urquhart
G
G
Edwards
R
R
Downie
A
A
Poon
F W
FW
D000368:Aged; D000369:Aged, 80 and over; D003112:Colonic Pseudo-Obstruction / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000453:epidemiology*; D007418:Intestinal Pseudo-Obstruction; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology