Comparison of uncovered stent with covered stent for treatment of malignant colorectal obstruction.
BACKGROUND
Insertion of self-expandable metallic stents (SEMS) can provide rapid relief of malignant colorectal obstruction and can be used as a palliative treatment or as a bridge to surgery. A SEMS can be classified as an uncovered or covered stent. Both types of stents have their own merits and demerits.


OBJECTIVE
The objectives of this study were to compare success rates, durability, and complication rates of uncovered and covered stent groups of malignant colorectal obstruction. DESIGNS AND SETTING: A nonrandomized prospective, single-center study.


METHODS
We studied 80 patients with malignant colorectal obstruction: colon cancer in 70 patients, metastatic lesion of advanced gastric cancer in 8 patients, and cervix cancer in 2 patients. Insertion of uncovered stents was attempted in 39 patients (before surgery in 20, palliative in 19), and covered stents were used in 41 (before surgery in 23, palliative in 18).


METHODS
The stent was inserted into the obstructive sites for preoperative or palliative purposes by using the through-the-scope method. After stent insertion, the patients had regular follow-ups, either as clinical checkups or telephone interviews.


METHODS
Insertion success rate, durability, and complication rate according to stent type.


RESULTS
Technical and clinical success rates of uncovered and covered stents were not different (100%; 95.1%, P > .05, 100%; 97.4%, P > .05). The early stent migration rate was not different in both groups. The late stent migration was more common in the covered stent group than the uncovered stent group (0% vs 40%, respectively, P = .005). Loss of stent function during the long-term follow-up period was more frequent in the covered stent group than in the uncovered stent group (18.8% vs 60%, respectively, P = .018).


CONCLUSIONS
This was a small-sized, nonrandomized, prospective, single-center study. Confirmation of large-scale, multicenter, randomized, prospective outcome is required.


CONCLUSIONS
Insertion of either an uncovered or covered stent is similarly an effective treatment modality of malignant colorectal obstruction for preoperative purposes. However, there are no advantages of covered stents over uncovered stents during the follow-up period in the palliative purpose.
Lee
Kee Myung
KM
Department of Gastroenterology Ajou University School of Medicine, Suwon, Korea.
Shin
Sung Jae
SJ
Hwang
Jae Chul
JC
Cheong
Jae Youn
JY
Yoo
Byung Moo
BM
Lee
Kwang Jae
KJ
Hahm
Ki Baik
KB
Kim
Jin Hong
JH
Cho
Sung Won
SW
D003106:Colon; D003110:Colonic Neoplasms / Q000150:complications / Q000556:secondary / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011300:Preoperative Care; D015607:Stents / Q000009:adverse effects / Q000592:standards; D013274:Stomach Neoplasms / Q000473:pathology; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology