The clinical outcomes of the radiologic method for self-expandable metal-stent placement in patients with colorectal obstruction: A prospective study

Abstract

Objectives: To assess the clinical outcomes of self-expandable metal stent (SEMS) placement for patients with colorectal obstruction.

Methods: A total of 61 patients underwent SEMS placement using computerized tomography (CT) to confirm malignancy of intrinsic origin and evaluate the exact location, notch, and extent of the disruptive laceration.

Results: The overall technical success rate and clinical success rate of SEMS placement using the radiological method were 59 (96.7%) and 57 (93.4%), respectively. The technical success rate and clinical success rate of SEMS placement in the palliative and bridge to elective surgery (BTS) groups were 35 (97.2%), 24 (96.0%), 33 (91.7%), and 24 (96.0%). The median cumulative primary stent patency duration and patients' survival of SEMS placement was 123 days (95% CI, 65-123 days), and 133 days (95% CI, 72-133 days). The median cumulative primary stent patency duration and patient survival did not differ significantly between the palliative group 119 days; (95% CI, 59-119 days), 128 days; (95% CI, 71-128 days), and the BTS group 120 days; (95% CI, 68-120 days; p = 0.362), 130 days; (95% CI, 78-130 days); p = 0.412).

Conclusions: The colorectal obstruction had convoluted with curved angulation and located mainly at the rectum, sigmoid, descending colon, and the radiologic method of SEMS placement has more efficacious with a high technical and clinical success rate. However, SEMS placement was highly technical, and clinical success with median stent patency and patient survival did not differ significantly between the palliative group and the BTS group.

Keywords: Bridge to elective surgery; Colorectal obstruction; Interventional radiology; Palliative; Stent.