Malignant colorectal obstruction treated by means of self-expanding metallic stents: effectiveness before surgery and in palliation

Radiology. 2000 Aug;216(2):492-7. doi: 10.1148/radiology.216.2.r00au12492.

Abstract

Purpose: To determine the effectiveness and safety of metallic stents in the treatment of malignant colorectal obstruction before surgery and for palliation.

Materials and methods: Eighty patients with acute malignant colorectal obstruction presumed to be malignant were treated by means of implanting self-expanding metallic stents.

Results: Stent placement was successful in 70 of the 80 patients and resolved bowel obstruction in 67 patients (96%). Two patients had colonic perforation and developed peritonitis 18 and 24 hours after stent placement; one patient died as a consequence. Thirty-three patients underwent elective surgery after 7 days +/- 3 (SD; range, 4-10 days), and adequate tumoral coverage and cleansing of the colon were observed in all patients. Stent placement was used as final palliative treatment in another 35 patients. Patient follow-up lasted a mean of 138 days +/- 93 (range, 36-334 days). The survival rate for the palliative group was 55% at 3 months, 44% at 6 months, and 25% at 9 months. The estimated primary stent patency rate was 91% at 3 and 6 months.

Conclusion: Management of colorectal obstruction by using metallic stents was effective and safe, although colonic perforation is a potential complication. In cases of palliation, the method may obviate palliative colostomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Colonic Diseases / etiology
  • Colonic Diseases / surgery
  • Colonic Diseases / therapy*
  • Colonic Neoplasms / complications*
  • Colonic Neoplasms / surgery
  • Elective Surgical Procedures
  • Equipment Design
  • Female
  • Fluoroscopy
  • Follow-Up Studies
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / surgery
  • Intestinal Obstruction / therapy*
  • Intestinal Perforation / etiology
  • Male
  • Metals
  • Middle Aged
  • Palliative Care*
  • Peritonitis / etiology
  • Radiography, Interventional
  • Rectal Diseases / etiology
  • Rectal Diseases / surgery
  • Rectal Diseases / therapy*
  • Rectal Neoplasms / complications*
  • Rectal Neoplasms / surgery
  • Safety
  • Sigmoid Diseases / etiology
  • Sigmoid Diseases / surgery
  • Sigmoid Diseases / therapy
  • Stents* / adverse effects
  • Survival Rate

Substances

  • Metals