title: Clinical outcomes of palliative self-expanding metallic stents in patients with malignant colorectal obstruction.
abstract: OBJECTIVE
  Self-expanding metallic stents (SEMS) are useful palliative option and a bridge to surgery in malignant colorectal obstruction. The aim of this study was to evaluate the clinical outcomes of SEMS to palliate colorectal malignant obstruction.
  
  
  METHODS
  Malignant colorectal obstructive patients who underwent SEMS insertion at the National Cancer Center, Korea from January 2004 to June 2008 were enrolled in the study. Patients' clinical characteristics, outcomes and complications for palliative SEMS insertion were retrospectively analyzed.
  
  
  RESULTS
  A total of 54 patients were enrolled in the palliative SEMS group and 48 patients with obstructive CRC were included in the SEMS as the bridge to surgery group. Obstruction of the left colon occurred in 52 patients of the palliative SEMS group and all patients in SEMS as bridge to surgery group. For primary SEMS insertion, the technical success (TS) rate was 87.0% and the clinical success (CS) rate 89.4%, while the rates of early and late complications were 24.1% and 23.4%, respectively. There was no procedure-related mortality. Stent migration rate was higher in the cases treated with small diameter and covered type of stents. Median time to reobstruction and migration were 85 and 101 days, respectively. TS and CS rates for SEMS reinsertion were comparable to those for primary SEMS insertion.
  
  
  CONCLUSIONS
  Palliative SEMS are effective and favorable procedures for malignant colorectal obstruction but with some complications. Stent migration is associated with covered type and small diameter stents while other factors including length of stent and chemotherapy do not affect stent complications in the present study.
authors.affiliation: Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea. mdzara@ncc.re.kr
authors.forename: Byung Chang
authors.initials: BC
authors.lastname: Kim
authors.forename: Kyung Su
authors.initials: KS
authors.lastname: Han
authors.forename: Chang Won
authors.initials: CW
authors.lastname: Hong
authors.forename: Dae Kyung
authors.initials: DK
authors.lastname: Sohn
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Park
authors.forename: Sung Chan
authors.initials: SC
authors.lastname: Park
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Baek
authors.forename: Hyo Seong
authors.initials: HS
authors.lastname: Choi
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Chang
authors.forename: Dae Yong
authors.initials: DY
authors.lastname: Kim
authors.forename: Jae Hwan
authors.initials: JH
authors.lastname: Oh
mesh_terms: D015179:Colorectal Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D005548:Foreign-Body Migration; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D010166:Palliative Care / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome