title: Clinical application of self-expandable metallic stent for treatment of colorectal obstruction caused by extrinsic invasive tumors.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University, College of Medicine, Seoul, South Korea.
authors.forename: Sung Jae
authors.initials: SJ
authors.lastname: Shin
authors.forename: Tae Il
authors.initials: TI
authors.lastname: Kim
authors.forename: Byung Chang
authors.initials: BC
authors.lastname: Kim
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Lee
authors.forename: Si Young
authors.initials: SY
authors.lastname: Song
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Kim
mesh_terms: 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
chemical_list: D008670:Metals