title: Self-Expanding Metallic Stents (SEMS) in Left-Sided Colonic Cancer--a Cancer Center Experience.
abstract: OBJECTIVE
  Self-Expanding Metallic Stents (SEMS) are a surgery-sparing option for malignant colonic obstruction. They can be inserted as a "bridge to surgery" (BTS) for potentially curable disease, or as a palliative measure, thereby avoiding the higher morbidity and mortality associated with surgery. The objective of this study was to report our local experience of left-sided colonic stents.
  
  
  METHODS
  Data on 49 patients was collected retrospectively from Oct 2008 to Nov 2014 at our cancer centre. This included demographics, baseline clinical characteristics, indications for SEMS placement (bridge to surgery/palliative), technical and clinical success, complications, and the mean patency of duration. Survival in both groups was also plotted on a Kaplan-Meier chart.
  
  
  RESULTS
  A total of 49 patients with colorectal carcinoma (CRC) of the left side were enrolled. The mean age was 50 years (range 18-86). Ninety percent of patients had disease involving the rectum, sigmoid colon, or both. Forty-seven percent (n = 23) of patients had stent insertion as a BTS, whereas 53% (n = 26) had the procedure with palliative intent. Technical and clinical success rates were 96 and 88%, respectively. The clinical success rate of the palliative arm was lower than that of the BTS arm (p = 0.024). 87.5% (n = 42) had no procedure-related complications. Technical failure, perforation, and stent migration/expulsion, were each observed in 4% of cases. Mean stent patency duration was 83.9 days.
  
  
  CONCLUSIONS
  SEMS insertion for left-sided malignant colonic obstruction is a safe and effective procedure when used either as a bridge to surgery or with palliative intent.
authors.affiliation: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan. kamranmuddasar@skm.org.pk.
authors.forename: Kamran Muddasar
authors.initials: KM
authors.lastname: Saeed
authors.affiliation: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan.
authors.forename: Waleed
authors.initials: W
authors.lastname: Zafar
authors.affiliation: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan.
authors.forename: Muhammad Adnan
authors.initials: MA
authors.lastname: Masood
authors.affiliation: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan.
authors.forename: Shahid
authors.initials: S
authors.lastname: Khattak
authors.affiliation: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan.
authors.forename: Aamir Ali
authors.initials: AA
authors.lastname: Syed
authors.affiliation: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan.
authors.forename: Muhammed Aasim
authors.initials: MA
authors.lastname: Yusuf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016522:Oncology Service, Hospital; D010166:Palliative Care; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bridge to surgery; Colonic obstruction; Colorectal carcinoma; Self expanding metallic stents