title: Radiological Position and Clinical Outcome of Preoperative Self-Expanding Metal Stents for Obstructing Colonic Cancer: A Single-Centre Cohort Study.
abstract: BACKGROUND
  Preoperative placement of self-expanding metal stents is used in patients with obstructing colon carcinoma to prevent an emergency operation. The perceived benefits remain the subject of discussion. The data-evaluating function and complications of stents in relation to radiological position are limited.
  
  
  METHODS
  Patients receiving a preoperative stent between 2003 and 2013 were retrospectively analysed in this single-centre study. We analysed radiological deployment, eccentricity and angulation of the stent directly after placement. Endpoints were clinical success (resolution of ileus), complications needing non-elective surgery (blow-out, perforation, persistent ileus, dislocation) and other complications (bleeding, infiltrate). Associations were corrected for other potential influences.
  
  
  RESULTS
  Eighty-two patients were included. In 22 patients (26.8%), the stent was placed proximal to the splenic flexure. Clinical success was present in 85.4%. Twenty-two patients (26.8%) had a complication of which 16 (19.5%) underwent urgent surgery for insufficient functioning of the stent; there were two blow-outs (2.4%). A more symmetrically placed stent was associated with clinical success (p = 0.042), with large overlap between groups. However, no association was found with non-elective surgery or complications. Also, angulation and deployment were unassociated with these outcomes.
  
  
  CONCLUSIONS
  We could not establish an association between symmetry, angulation or deployment of self-expandable colonic stents with clinical success and complications.
authors.affiliation: Department of Gastroenterology and Hepatology, Deventer Hospital, Deventer, The Netherlands.
authors.forename: Eline H
authors.initials: EH
authors.lastname: van den Berg
authors.forename: Jilling F
authors.initials: JF
authors.lastname: Bergmann
authors.forename: Michiel
authors.initials: M
authors.lastname: Ledeboer
authors.forename: Rob A J M
authors.initials: RA
authors.lastname: van Dijk
authors.forename: Robbert J I
authors.initials: RJ
authors.lastname: Bosker
authors.forename: Frank
authors.initials: F
authors.lastname: Ter Borg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D003110:Colonic Neoplasms / Q000150:complications* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D016896:Treatment Outcome