[Endoscopic insertion of self-expanding metal stents in malignant colonic obstructions].
OBJECTIVE
Self-expanding metal stents are being increasingly used to resolve malignant colonic obstruction. Subsequently, patients can either undergo elective surgery, or the stent can serve as a definitive palliative treatment in patients unfit for surgery. We present our experience with this technique in our hospital, a level II center within the Spanish National Health Service, which can be considered a community hospital.


METHODS
A retrospective study was performed of a 42-month period (May 2002 to October 2005), during which malignant colonic obstruction was treated by means of endoscopically inserted stents on 43 occasions in 40 patients.


RESULTS
Stent insertion was successfully performed in 41 attempts (95%) and good clinical results were obtained on 37 occasions (86%). Endoscopic means alone were used on 23 occasions (53.5%) and in the remaining 20 (46.5%), both endoscopy and fluoroscopy were employed. Of 38 patients with successfully inserted stents, clinical success was achieved, as a whole, in 34. Twenty-four of these patients (63%) subsequently underwent elective surgery while the stent served as a definitive palliative treatment in the remaining 14 (37%). One of these patients had to undergo further surgery due to a fistula between the colon and the bladder. There were eight other complications: three stent migrations and one stent obstruction occurred, two patients had tenesmus, one patient developed bacteremia after stent insertion, and a silent bowel perforation by the stent was found in an elective surgical procedure. There was no mortality.


CONCLUSIONS
In our experience, endoscopically inserted stents seem to be a safe and effective method for the initial treatment of malignant colonic obstruction.
García-Cano
Jesús
J
Sección de Aparato Digestivo, Hospital Virgen de la Luz, Cuenca, España. j.garcia-cano@terra.es
Sánchez-Manjavacas
Natividad
N
Gómez Ruiz
Carmen Julia
CJ
Pérez García
José Ignacio
JI
Redondo Cerezo
Eduardo
E
Viñuelas
Miriam
M
Morillas Ariño
María Julia
MJ
Pérez Vigara
María Gracia
MG
Pérez Sola
Angel
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000150:complications; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents