Self-expandable Metallic Stents Contribute to Reducing Perioperative Complications in Colorectal Cancer Patients with Acute Obstruction

Anticancer Res. 2018 Mar;38(3):1749-1753. doi: 10.21873/anticanres.12411.

Abstract

Background/aim: The self-expandable metallic stent (SEMS) is an excellent non-invasive tool for emergent bowel obstruction. This study was designed to evaluate the clinical usefulness of the SEMS for avoiding perioperative complications.

Patients and methods: We analyzed a total of 47 consecutive patients who had a bowel obstruction due to colorectal cancer at initial diagnosis between 2012 and 2017 from hospital records.

Results: Perioperative complications occurred in 30% (14/47) of patients. Univariate and multivariate logistic regression analyses identified an age of more than 75 years [p=0.037, OR=6.84 (95% CI=1.11-41.6)] and the absence of an SEMS treatment [p=0.028, OR=18.5 (95% CI=1.36-250.0)] as independent risk factors for perioperative complications. Pneumonia (12.7% (6/47)) was the most common complication. There were no pneumonia patients (0% (0/15)) who were treated with the SEMS. In contrast to patients with the non-SEMS treatment, 18.7% (6/32) of all patients and 35.7% (5/14) of elderly patients had pneumonia.

Conclusion: The SEMS is a safe and effective treatment for avoiding perioperative complications, particularly pneumonia, and may be a crucial strategy in elderly patients with acute obstruction due to colorectal cancer.

Keywords: Self-expandable metallic stent; colonic obstruction; colorectal cancer; complication; pneumonia.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / surgery*
  • Female
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / surgery*
  • Logistic Models
  • Male
  • Metals / chemistry*
  • Middle Aged
  • Multivariate Analysis
  • Perioperative Period
  • Pneumonia / prevention & control
  • Postoperative Complications / prevention & control
  • Stents*
  • Treatment Outcome

Substances

  • Metals