title: Efficacy and complications in the use of self-expanding colonic stents: an analysis of 15 years' experience.
abstract: OBJECTIVE
  To analyze the efficacy and safety of the procedure for placing self-expanding stents in the colon. To evaluate the factors associated with complications. To analyze the dose of radiation delivered in the procedure.
  
  
  METHODS
  This was a retrospective descriptive study of 478 procedures done at a single center to place self-expanding metallic stents in the colon. A total of 423 nitinol stents and 79 stainless steel stents were placed. We included all colonic obstructions, of which 446 had malignant causes and 8 had benign causes. We excluded patients with intestinal perforation, severe colonic bleeding, short life expectancy, or lesions located less than 5 cm from the anus. We collected the dosimetric data and analyzed the technical success, clinical success, and complications during follow-up.
  
  
  RESULTS
  The procedure was a technical success in 92.26% of cases (n=441) and a clinical success in 78.45% (n=375); complications occurred during follow-up in 18.5% of cases. Complications occurred more frequently with the stainless steel stents than with the nitinol stents (OR: 3.2; 95% CI: 1.8-5.7). The mean value of the dose area product was 35 Gy*cm(2). When instead of being done by the interventional radiologist working together with an endoscopist the procedure was done exclusively by the interventional radiologist, the time under fluoroscopy (p=0.001), dose area product (p=0.029), and kinetic energy released per unit mass (p=0.001) were greater.
  
  
  CONCLUSIONS
  The procedure for placing self-expanding colonic stents is efficacious and safe with an acceptable rate of complications. The doses of radiation delivered were low, and the radiation doses and time under fluoroscopy were lower when the procedure was done together with an endoscopist.
authors.affiliation: Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de León, León, España. Electronic address: samper.wamba@gmail.com.
authors.forename: J D
authors.initials: JD
authors.lastname: Samper Wamba
authors.affiliation: Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de León, León, España.
authors.forename: A
authors.initials: A
authors.lastname: Fernández Martínez
authors.affiliation: Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de León, León, España.
authors.forename: L
authors.initials: L
authors.lastname: González Pastrana
authors.affiliation: Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de León, León, España.
authors.forename: L
authors.initials: L
authors.lastname: López González
authors.affiliation: Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de León, León, España.
authors.forename: Ó
authors.initials: Ó
authors.lastname: Balboa Arregui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000601:surgery*; D003110:Colonic Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: Carcinoma colorrectal; Colon; Colorectal carcinoma; Fluoroscopia; Fluoroscopy; Prótesis autoexpandibles; Self-expanding stents