Clinical application of self-expandable metallic stent for treatment of colorectal obstruction caused by extrinsic invasive tumors.
OBJECTIVE
The purpose of this study was to extend the application of self-expandable metallic stents by investigating their usefulness in treating colorectal obstructions caused by unresectable extrinsic tumors.


METHODS
From January 2000 to November 2005, a total of 60 colorectal stenting procedures were performed, and 57 stents were deployed in 39 patients with extrinsic tumors. The success rate and complications were analyzed retrospectively.


RESULTS
The most common etiology and location of obstruction were advanced gastric cancer and transverse colon. Technical success was 34 of 39 patients (87.2 percent). The causes of technical failure were immediate stent migration (n = 1), technical problems (n = 1), and access failure because of bowel immobilization (n = 3). Clinical success was 32 of 34 technical successes (82.1 percent). The two patients without clinical success had multifocal strictures of the bowel. Complications occurred in 22 of 57 stents (38.6 percent), including stent reobstruction (n = 14) and stent migration (n = 5). All of stent migrations except one developed with covered stents.


CONCLUSIONS
In patients with colonic obstruction caused by extrinsic tumors, stent insertion provided effective symptom relief and can be a reasonable alternative choice to a colostomy. An uncovered stent might be more preferable, considering less migration and remaining short life expectancy, compared with a covered stent.
Shin
Sung Jae
SJ
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University, College of Medicine, Seoul, South Korea.
Kim
Tae Il
TI
Kim
Byung Chang
BC
Lee
Yong Chan
YC
Song
Si Young
SY
Kim
Won Ho
WH
D016009:Chi-Square Distribution; D003108:Colonic Diseases / Q000209:etiology* / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000150:complications*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005471:Fluoroscopy; D005548:Foreign-Body Migration; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008670:Metals; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications*; D015996:Survival Rate; D016896:Treatment Outcome
D008670:Metals