Comparison of efficacies between stents for malignant colorectal obstruction: a randomized, prospective study.
BACKGROUND
Colonoscopic insertion of a self-expandable metallic stent (SEMS) has been widely performed for the treatment of malignant colorectal obstruction. Different types of stents could influence the efficacy and complication rate of stent use.


OBJECTIVE
To compare the efficacy and complication rates between two SEMSs, the uncovered WallFlex stent and the covered Comvi stent.


METHODS
A prospective, randomized study.


METHODS
Tertiary-care academic medical center.


METHODS
Between 2007 and 2009, a total of 151 patients with malignant colorectal obstruction were enrolled.


METHODS
Two types of colorectal SEMSs (the uncovered WallFlex stent by Boston Scientific Corp and the newly developed covered Comvi stent by Taewoong Medical Co) were inserted.


METHODS
Technical success, clinical success, stent patency, and complication rate according to stent type.


RESULTS
Technical failure occurred in 2 patients (1.3%); one was in the WallFlex group and the other in the Comvi group. Clinical failure developed in 9 patients (6.0%): 6 patients from the WallFlex group and 3 from the Comvi group. Complications because of cancer infiltration occurred more frequently in the WallFlex group (14.5% vs 3.8%). However, the rate of stent migration was higher in the Comvi group (21.1% vs 1.8%). The mean patency of the stent did not differ between the two groups (P = .50).


CONCLUSIONS
This was a single-center study.


CONCLUSIONS
Both uncovered WallFlex and covered Comvi stents were suitable for relieving malignant colorectal obstruction. Tumor ingrowth was more common in the WallFlex group, but stent migration was more common in the Comvi group.
Park
Semi
S
Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Cheon
Jae Hee
JH
Park
Jae Jun
JJ
Moon
Chang Mo
CM
Hong
Sung Pil
SP
Lee
Sang-Kil
SK
Kim
Tae Il
TI
Kim
Won Ho
WH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult