title: Long-term success of colonic stent insertion is influenced by indication but not by length of stent or site of obstruction.
abstract: BACKGROUND
  Stent insertion plays an important part in the management of acute colonic obstruction. There are limited data on factors influencing short- and long-term success.
  
  
  OBJECTIVE
  We investigated indications, technical and clinical success rates, complication rates and the factors influencing them. Patients were identified from our prospective colonic stent database (2000-2008).
  
  
  RESULTS
  One hundred and four stents were attempted in 96 patients (technical success rate, 83.3%). Clinical short-term success was observed in 74 (77.1%) patients. Follow-up data available for 57 patients showed clinical long-term success in 77% (44/57). Multiple logistic regression analysis showed a significant decline in technical success over the study period (p = 0.041). Patients with colonic malignancy had significantly higher long-term success rates (81%), compared to those with extra-colonic malignancies (43%) (p = 0.049). Length of stent and site of obstruction were not significant factors. Early complications occurred in 10%, and late complications, in 26.3% of cases.
  
  
  CONCLUSIONS
  Colonic stent insertion provides symptom relief in over 70% when used as a long-term solution. Complication rates are high, and a significant minority of patients requires re-intervention. Obstruction caused by extra-colonic malignancy is far less likely to be permanently palliated by a stent, in comparison to colonic malignancy.
authors.affiliation: Department of Gastroenterology, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, Manchester, UK. Christian.selinger@web.de
authors.forename: Christian P
authors.initials: CP
authors.lastname: Selinger
authors.forename: Jayapal
authors.initials: J
authors.lastname: Ramesh
authors.forename: Derrick F
authors.initials: DF
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome