Abstract
Objectives: To evaluate the short- and long-term efficacy of self-expanding metal stents (SEMSs) in patients with colorectal obstruction and incurable cancer and the related factors that affect outcomes. Design: Retrospective analysis of SEMS placement for incurable colorectal obstruction in a 3-year period. Setting: Five tertiary care endoscopic centers. Patients and Intervention: Consecutive patients (N=201) undergoing stenting for incurable malignant obstruction. Main Outcome Measurements: Clinical and technical success of stenting, complications rate, and factors affecting outcomes. Results: Technical success was achieved in 184 of 201 patients (91.5%) and clinical success occurred in 165 of 184 patients (89.7%; 82.1% of 201 patients). Technicaland clinical failures were more frequent in extrinsic and long colorectal stenoses. Overall, 165 patients had normal bowel movements during follow-up (mean [SD], 115.5 [100.3] days; range, 1-500 days), 15 developed complications, 127 had a functioning SEMS at the time of death, and 23 were alive at completion of the study. Twenty-four (11.9%) major complications occurred: 11 migrations, 12 perforations, and 1 reobstruction. Migration of SEMSs was associated with stent diameter less than 25 mm. Bevacizumab therapy increased the risk of perforation by 19.6-fold. Karnofsky performance status of 50 or less was associated with shorter survival and a 3.7- fold higher risk of death within 6 months after the stent was placed. Conclusions: The use of SEMSs is safe and effective for palliation of incurable malignant colonic obstruction; approximately 75% of patients with SEMSs are able to avoid colostomy.
| Original language | English |
|---|---|
| Pages (from-to) | 1157-1162 |
| Number of pages | 6 |
| Journal | Archives of Surgery |
| Volume | 146 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 2011 |
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ASJC Scopus subject areas
- Surgery
Cite this
Endoscopic palliation in patients with incurable malignant colorectal obstruction by means of self-expanding metal stent : Analysis of results and predictors of outcomes in a large multicenter series. / Manes, Gianpiero; De Bellis, Mario; Fuccio, Lorenzo; Repici, Alessandro; Masci, Enzo; Ardizzone, Sandro; Mangiavillano, Benedetto; Carlino, Alessandra; Rossi, Giovanni Battista; Occhipinti, Pietro; Cennamo, Vincenzo.
In: Archives of Surgery, Vol. 146, No. 10, 10.2011, p. 1157-1162.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Endoscopic palliation in patients with incurable malignant colorectal obstruction by means of self-expanding metal stent
T2 - Analysis of results and predictors of outcomes in a large multicenter series
AU - Manes, Gianpiero
AU - De Bellis, Mario
AU - Fuccio, Lorenzo
AU - Repici, Alessandro
AU - Masci, Enzo
AU - Ardizzone, Sandro
AU - Mangiavillano, Benedetto
AU - Carlino, Alessandra
AU - Rossi, Giovanni Battista
AU - Occhipinti, Pietro
AU - Cennamo, Vincenzo
PY - 2011/10
Y1 - 2011/10
N2 - Objectives: To evaluate the short- and long-term efficacy of self-expanding metal stents (SEMSs) in patients with colorectal obstruction and incurable cancer and the related factors that affect outcomes. Design: Retrospective analysis of SEMS placement for incurable colorectal obstruction in a 3-year period. Setting: Five tertiary care endoscopic centers. Patients and Intervention: Consecutive patients (N=201) undergoing stenting for incurable malignant obstruction. Main Outcome Measurements: Clinical and technical success of stenting, complications rate, and factors affecting outcomes. Results: Technical success was achieved in 184 of 201 patients (91.5%) and clinical success occurred in 165 of 184 patients (89.7%; 82.1% of 201 patients). Technicaland clinical failures were more frequent in extrinsic and long colorectal stenoses. Overall, 165 patients had normal bowel movements during follow-up (mean [SD], 115.5 [100.3] days; range, 1-500 days), 15 developed complications, 127 had a functioning SEMS at the time of death, and 23 were alive at completion of the study. Twenty-four (11.9%) major complications occurred: 11 migrations, 12 perforations, and 1 reobstruction. Migration of SEMSs was associated with stent diameter less than 25 mm. Bevacizumab therapy increased the risk of perforation by 19.6-fold. Karnofsky performance status of 50 or less was associated with shorter survival and a 3.7- fold higher risk of death within 6 months after the stent was placed. Conclusions: The use of SEMSs is safe and effective for palliation of incurable malignant colonic obstruction; approximately 75% of patients with SEMSs are able to avoid colostomy.
AB - Objectives: To evaluate the short- and long-term efficacy of self-expanding metal stents (SEMSs) in patients with colorectal obstruction and incurable cancer and the related factors that affect outcomes. Design: Retrospective analysis of SEMS placement for incurable colorectal obstruction in a 3-year period. Setting: Five tertiary care endoscopic centers. Patients and Intervention: Consecutive patients (N=201) undergoing stenting for incurable malignant obstruction. Main Outcome Measurements: Clinical and technical success of stenting, complications rate, and factors affecting outcomes. Results: Technical success was achieved in 184 of 201 patients (91.5%) and clinical success occurred in 165 of 184 patients (89.7%; 82.1% of 201 patients). Technicaland clinical failures were more frequent in extrinsic and long colorectal stenoses. Overall, 165 patients had normal bowel movements during follow-up (mean [SD], 115.5 [100.3] days; range, 1-500 days), 15 developed complications, 127 had a functioning SEMS at the time of death, and 23 were alive at completion of the study. Twenty-four (11.9%) major complications occurred: 11 migrations, 12 perforations, and 1 reobstruction. Migration of SEMSs was associated with stent diameter less than 25 mm. Bevacizumab therapy increased the risk of perforation by 19.6-fold. Karnofsky performance status of 50 or less was associated with shorter survival and a 3.7- fold higher risk of death within 6 months after the stent was placed. Conclusions: The use of SEMSs is safe and effective for palliation of incurable malignant colonic obstruction; approximately 75% of patients with SEMSs are able to avoid colostomy.
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U2 - 10.1001/archsurg.2011.233
DO - 10.1001/archsurg.2011.233
M3 - Article
VL - 146
SP - 1157
EP - 1162
JO - Archives of Surgery
JF - Archives of Surgery
SN - 0004-0010
IS - 10
ER -