Outcomes of Self-Expanding Metal Stents in Malignant Colonic Obstruction are Independent of Location or Length of the Stenosis: Results of a Retrospective, Single-Center Series

Dig Surg. 2018;35(3):230-235. doi: 10.1159/000477821. Epub 2017 Aug 16.

Abstract

Aim: To evaluate the length and location of stenosis in the colon as predictors of technical and clinical outcomes of stent placement in patients presenting with obstructive colorectal cancer.

Methods: A prospective single-center cohort study of patients treated with a colonic stent for malignant obstruction, regardless of stenosis length or location. Stenosis length was assessed globally on the appropriate CT slice as well as by 3D CT reconstruction. We analyzed whether outcomes were different in patients with a right sided-tumor and/or a stenosis >4 cm long.

Results: One hundred forty-one patients were evaluated, 63 with a stenosis >4 cm, 48 with a stenosis proximal to the splenic flexure. Technical failure (n = 9) was mainly caused because of looping or due to the difficulty in engaging the stenosis precluding analysis of the relation between the stenosis length and technical success. Both measurement methods showed good agreement. Clinical outcomes were not associated with stenosis length or location.

Conclusion: Clinical outcomes of stenting did not differ between groups regardless of stenosis length or location. Measuring stenosis length more precisely using 3D CT reconstructions is not of help.

Keywords: Colon cancer; Large bowel obstruction; Self-expanding metallic stents.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colonic Diseases / etiology
  • Colonic Diseases / pathology
  • Colonic Diseases / therapy*
  • Colorectal Neoplasms / complications*
  • Female
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / pathology
  • Intestinal Obstruction / therapy*
  • Logistic Models
  • Male
  • Middle Aged
  • Retrospective Studies
  • Self Expandable Metallic Stents*
  • Treatment Outcome