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Gastrointest Endosc. 2007 Nov;66(5):920-7. Epub 2007 Sep 27.

Ultraflex precision colonic stent placement for palliation of malignant colonic obstruction: a prospective multicenter study.

Author information

1
Servizio di Endoscopia Digestiva, IRCCS Istituto Clinico Humanitas, Milano, Italy.

Abstract

BACKGROUND:

Many patients who develop obstructive colonic symptoms secondary to inoperable colorectal cancer will require palliative treatment. A minimally invasive and potentially long-lasting approach is placement of nitinol self-expanding metal stents (SEMS).

OBJECTIVE:

To determine the effectiveness and safety of a nitinol SEMS designed for colorectal use in the palliative treatment of malignant colonic obstruction.

DESIGN:

Prospective multicenter clinical study.

SETTING:

Nine European study centers.

PATIENTS:

Forty-four patients with malignant colonic obstruction.

INTERVENTIONS:

Placement of nitinol SEMS designed for colorectal use.

MAIN OUTCOME MEASURES:

Technical success, defined as accurate SEMS deployment with adequate stricture coverage, and clinical success, defined as decompression and relief of obstructive colonic symptoms maintained without intervention or serious device-related complications.

RESULTS:

Technical success was attained in 95% of patients, with 95% CI 85%-99%. After 6 months, the rate of clinical success was 81%, 95% CI 69%-96%. Survival at 6 months was 67%, 95% CI 54%-84%. Clinical success was maintained until death in 86% of the nonsurvivors. No perforations or SEMS-related deaths occurred.

LIMITATION:

This investigation was nonrandomized and did not include a control group.

CONCLUSIONS:

In a large prospective investigation, palliative placement of a nitinol SEMS designed for colorectal use was accomplished with a high rate of technical success. Durable clinical success was achieved in a high proportion of patients with low morbidity.

PMID:
17904133
DOI:
10.1016/j.gie.2007.03.1042
[Indexed for MEDLINE]

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