title: Self-expanding metal stenting for obstructing left colon cancer: A district hospital experience.
abstract: Stenting of malignant colonic obstructions using self-expanding metal stents (SEMS) is commonly used for palliation and can be used as an interim procedure prior to definitive surgery. We retrospectively reviewed prospectively collected data from all consecutive colonic stenting procedures undertaken between September 2007 and December 2014 at a district general hospital. Technical and clinical success rates, mortality, colonic perforation, and other complications were documented and analyzed. Sixty-four colonic stenting procedures were undertaken. Fifty-three (83 %) were for palliation and eleven (17 %) were performed as a bridge to definitive surgery. Technical (98.4 %) and clinical (89.9 %) success rates were excellent. The single documented failure was secondary to complete luminal obstruction. Three stent occlusions (4.6 %), one colonic perforation (1.5 %), and one migration were encountered. There were no procedure-related deaths. Colonic stenting for obstructing left-sided colon cancer is a safe and effective procedure, even in the district general hospital setting. The use of SEMS as a bridge to elective surgery balances surgical and oncological considerations and, therefore, is most appropriate for high surgical risk patients in this setting.
authors.affiliation: Department of General and Colorectal Surgery, Queen Elizabath The Queen Mother Hospital, Margate, CT9 4AN, UK. kphmohan@yahoo.co.uk.
authors.forename: Mohan Raj
authors.initials: MR
authors.lastname: Harilingam
authors.affiliation: Department of General and Vascular Surgery, Kent and Canterbury Hospital, Ethelbert Road, Canterbury, CT1 3NG, UK.
authors.forename: Amjad
authors.initials: A
authors.lastname: Khushal
authors.affiliation: Department of General and Vascular Surgery, Kent and Canterbury Hospital, Ethelbert Road, Canterbury, CT1 3NG, UK.
authors.forename: Abdulmalik
authors.initials: A
authors.lastname: Aikoye
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000209:etiology* / Q000628:therapy*; D003110:Colonic Neoplasms / Q000150:complications*; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008670:Metals; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D008670:Metals
keywords: Colorectal cancer; Obstruction; Self-expanding metal stent