title: Outcomes after stenting for malignant large bowel obstruction without radiologist support.
abstract: OBJECTIVE
  To assess outcomes after colonic stent insertion for obstructing colorectal malignancies performed by an endoscopist without radiologist support.
  
  
  METHODS
  This is a retrospective study of all stents inserted by a single surgeon in a District General Hospital over an eight year period. All stents were inserted for patients with acute large bowel obstruction secondary to a malignant colorectal pathology either for palliation or as a bridge to surgery. Procedures were performed by a single surgeon endoscopically with fluoroscopic control in the X-ray department but without the support of an interventional radiologist. Data was collected prospectively on a pre-designed database.
  
  
  RESULTS
  The indication for all stent procedures was an obstructing colorectal malignancy. Out of 53 patients, the overall success rate was 90.6%. Eight patients had a stent intended as a bridge to surgery and 45 as a palliative procedure. Technical success was achieved in 50 out of 53 procedures (94.3%) and clinical success in 48 of those remaining 50 (96.0%). Those with unsuccessful technical or clinical procedures went on to have defunctioning stomas to treat their obstruction. There were six complications from the technically successful stents (12.0%). These included one migration, one persisting obstructive symptoms and four cases of tumour overgrowth of the stents at a later date. Haemorrhagic complications, perforation or mortality were not observed in our series. Our results are comparable to several other studies assessing stent outcomes for obstructing bowel cancer.
  
  
  CONCLUSIONS
  Our data suggests that colorectal stents can be inserted without radiologist support by an adequately trained individual with good outcomes.
authors.affiliation: Rao Khalid Mehmood, Jody Parker, Fayyaz Akbar, Eays Qasem, Department of Surgery, Betsi Cadwaladr University Health Board, Rhyl, North Wales LL18 5UJ, United Kingdom.
authors.forename: Rao Khalid
authors.initials: RK
authors.lastname: Mehmood
authors.affiliation: Rao Khalid Mehmood, Jody Parker, Fayyaz Akbar, Eays Qasem, Department of Surgery, Betsi Cadwaladr University Health Board, Rhyl, North Wales LL18 5UJ, United Kingdom.
authors.forename: Jody
authors.initials: J
authors.lastname: Parker
authors.affiliation: Rao Khalid Mehmood, Jody Parker, Fayyaz Akbar, Eays Qasem, Department of Surgery, Betsi Cadwaladr University Health Board, Rhyl, North Wales LL18 5UJ, United Kingdom.
authors.forename: Patricia
authors.initials: P
authors.lastname: Kirkbride
authors.affiliation: Rao Khalid Mehmood, Jody Parker, Fayyaz Akbar, Eays Qasem, Department of Surgery, Betsi Cadwaladr University Health Board, Rhyl, North Wales LL18 5UJ, United Kingdom.
authors.forename: Shakil
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Rao Khalid Mehmood, Jody Parker, Fayyaz Akbar, Eays Qasem, Department of Surgery, Betsi Cadwaladr University Health Board, Rhyl, North Wales LL18 5UJ, United Kingdom.
authors.forename: Fayyaz
authors.initials: F
authors.lastname: Akbar
authors.affiliation: Rao Khalid Mehmood, Jody Parker, Fayyaz Akbar, Eays Qasem, Department of Surgery, Betsi Cadwaladr University Health Board, Rhyl, North Wales LL18 5UJ, United Kingdom.
authors.forename: Eays
authors.initials: E
authors.lastname: Qasem
authors.affiliation: Rao Khalid Mehmood, Jody Parker, Fayyaz Akbar, Eays Qasem, Department of Surgery, Betsi Cadwaladr University Health Board, Rhyl, North Wales LL18 5UJ, United Kingdom.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Zeeshan
authors.affiliation: Rao Khalid Mehmood, Jody Parker, Fayyaz Akbar, Eays Qasem, Department of Surgery, Betsi Cadwaladr University Health Board, Rhyl, North Wales LL18 5UJ, United Kingdom.
authors.forename: Ernest
authors.initials: E
authors.lastname: Jehangir
mesh_terms: D015179:Colorectal Neoplasms / Q000150:complications / Q000601:surgery* / Q000628:therapy; D004724:Endoscopy; D005471:Fluoroscopy; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery* / Q000628:therapy; D007420:Intestine, Large / Q000473:pathology*; D010166:Palliative Care; D011446:Prospective Studies; D015642:Radiology, Interventional; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Colorectal cancer; Endoscopy; Interventional radiology; Palliation; Self-expanding colonic stents