Self-expandable metallic stents as palliative treatment for malignant colorectal obstruction.
BACKGROUND
In recent years, stent placement for malignant colorectal obstruction has become an accepted alternative to surgery. The purpose of this study was to evaluate the usefulness of self-expandable metallic stents (SEMS) as palliative management for patients with unresectable malignant colorectal obstruction.


METHODS
Twelve patients with unresectable malignant colorectal obstruction were treated with SEMS as palliative therapy. The sites of obstruction were located in the rectum (n = 9), the descending colon (n = 1), and the transverse colon (n = 2). All procedures were performed with combined endoscopic and fluoroscopic guidance. We analyzed the technical and clinical success rates of stent placement and the complications associated with the procedure.


RESULTS
The stents were successfully implanted and bowel obstruction was relieved in all cases; the technical and clinical success rates were 100%. Two complications occurred, including stent migration. There was no case requiring reintervention. All patients died of initial disease or another coexisting disease between 9 and 534 days (mean 133 +/- 148 days) after stent placement. None of the patients with stent in position at death had clinical or radiologic signs of bowel obstruction.


CONCLUSIONS
SEMS placement in patients with malignant colorectal obstruction is technically feasible and safe, making it useful as a palliative treatment.
Tsurumaru
Daisuke
D
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka City 812-8582, Japan. tsuru-d@radiol.med.kyushu-u.ac.jp
Hidaka
Hiromu
H
Okada
Satoko
S
Sakoguchi
Tarou
T
Matsuda
Hiroyuki
H
Matsumata
Takashi
T
Nomiyama
Hiroyuki
H
Utsunomiya
Takashi
T
Irie
Hiroyuki
H
Honda
Hiroshi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology; D015179:Colorectal Neoplasms / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007415:Intestinal Obstruction / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012007:Rectum / Q000473:pathology; D015607:Stents; D016896:Treatment Outcome