Factors associated with the long-term outcome of a self-expandable colon stent used for palliation of malignant colorectal obstruction.
BACKGROUND
The placement of self-expanding metal stents (SEMS) is a safe and effective definitive procedure for the palliation of malignant colorectal obstruction. In this study, the clinical outcomes, including the technical and clinical success rates, and the risk factors associated with the long-term outcomes of palliative SEMS were evaluated.


METHODS
From February 2002 to April 2008, 39 patients (18 men and 21 women) with malignant colorectal obstruction underwent placement of uncovered or covered stents under fluoroscopic or endoscopic guidance. The mean age of the patients was 64.5 +/- 14.6 years (range, 37-96 years).


RESULTS
The technical success rate was 100% (39/39), and the clinical success rate was 87.2% (34/39). Five cases had failed relief of the obstruction due to the development of migration in two patients, two malfunctions, and one perforation. Four patients experienced late complications: migration managed with a palliative colostomy in two patients, tumor ingrowth managed successfully with a second stent in one patient, perforation with an intraabdominal abscess at the upper margin of the stent 4 months after stenting in one patient. The location of the obstruction and the length of the stent were significant factors associated with a good outcome. Shorter stents (<10 cm) had better outcomes than longer stents (>or=10 cm; p = 0.008), and patients with a distal colorectal obstruction had better outcomes than those with a proximal colorectal obstruction (p = 0.015).


CONCLUSIONS
Patients with bowel obstruction involving a short segment and those with a distal obstruction had better stent outcomes.
Jung
Min Kyu
MK
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, 50 Samduk-Dong 2 Ga, Chung-Gu, Daegu 700-721, South Korea.
Park
Soo Young
SY
Jeon
Seong Woo
SW
Cho
Chang Min
CM
Tak
Won Young
WY
Kweon
Young Oh
YO
Kim
Sung Kook
SK
Choi
Yong Hwan
YH
Kim
Gab Chul
GC
Ryeom
Hun Kyu
HK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery*; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications; D010166:Palliative Care; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D012307:Risk Factors; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications