Safety and efficacy of gastrointestinal stents in cancer patients at a community hospital.
OBJECTIVE
Increasing scientific evidence supports the use of self-expanding metallic gastrointestinal (GI) stents. The commonly accepted primary indications are their usefulness as a bridge to surgery and for palliation to avoid surgery. These stents have been shown to have high technical success and low complication rates, leading to improved quality of life for patients. They have also been shown to be cost-effective when compared with alternative therapies. The objective of this study is to present a retrospective review of our local experience.


METHODS
Attempts were made to place 23 GI stents in 16 patients for palliative cancer indications.


RESULTS
Follow-up was 5-352 days (mean 81.9 d). Presenting symptoms included abdominal distention or pain (81%), nausea or vomiting (69%), constipation (31%) and weight loss (19%). Stents were placed in the colon (11 patients), duodenum (4 patients) or esophagus (1 patient). The technical success rate was 91.3%, the clinical success rate (defined as any improvement in symptoms in patients successfully receiving a stent) was 85.7%, and the complication rate was 21.4% among patients successfully receiving a stent, or 18.8% overall. Of 14 patients successfully receiving at least 1 stent, 10 (71%) were discharged home after a mean of 11.5 days (range 1-26 d). Of patients successfully receiving at least 1 stent, 12 (86%) had passed away at the time of last follow-up. Patients who successfully received a stent but who have since passed away (either in hospital or out of hospital) had their stent(s) in situ for a mean of 57 days (range 5-180 d).


CONCLUSIONS
On the basis of our data, we believe that GI stents may be safely and effectively used in a community hospital setting and that they provide benefit in the palliative care population.
Baerlocher
Mark Otto
MO
Radiology Residency Training Program, Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. mark.baerlocher@utoronto.ca
Asch
Murray R
MR
Vellahottam
Andrew
A
Puri
Gaurav
G
Andrews
Karen
K
Myers
Andy
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000401:mortality / Q000628:therapy*; D004379:Duodenal Neoplasms / Q000401:mortality / Q000628:therapy*; D004868:Equipment Failure / Q000706:statistics & numerical data; D004869:Equipment Safety; D004938:Esophageal Neoplasms / Q000401:mortality / Q000628:therapy*; D004940:Esophageal Stenosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D007415:Intestinal Obstruction / Q000401:mortality / Q000628:therapy*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010166:Palliative Care; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D015642:Radiology, Interventional; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome