Endoscopy 2019; 51(04): S210
DOI: 10.1055/s-0039-1681795
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Colon and rectum ePosters
Georg Thieme Verlag KG Stuttgart · New York

CLINICAL OUTCOMES OF PALLIATIVE COLORECTAL SELF-EXPANDABLE METAL STENT PLACEMENT: RESULTS OF A TWO-CENTER RETROSPECTIVE STUDY

O Yun
1   Endoscopy Department, City Clinical Hospital # 40, Moscow, Russian Federation
,
A Fedorov
2   Institute of Medicine, Department of Faculty Surgery, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
,
S Davydova
2   Institute of Medicine, Department of Faculty Surgery, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
,
A Klimov
2   Institute of Medicine, Department of Faculty Surgery, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Self-expandable metal stent placement is an established method of palliation for patients with malignant colorectal obstruction, but it can be challenging is cases of locally advanced cancer. The aim of the study was to evaluate early and long-term outcomes of palliative colorectal stenting.

Methods:

98 patients (median age – 68 years) presenting with symptomatic colorectal obstruction at the period of 2010 – 2018 in a Moscow city oncological hospital and a university surgical center were included in a retrospective two-center study. All patients were unfit for surgery due to advanced primary, recurrent or metastatic cancer of the large bowel or adjacent organs with the stenosis at the level of rectum (42), left colon (40), transverse colon (3) or right colon (13). Effectiveness of stent placement, adverse events and survival were analyzed.

Results:

Technical success was achieved in 96 cases (98%) with a good functional result in all stented patients. Early complications were observed in 8 patients (8,2%): colonic perforation with peritonitis (3), extraperitoneal rectal perforation (1), and distal migration of covered stents on 3 – 14 days after placement (4). All perforations occurred at the tumor site on the first (2), second (1) and eleventh (1) days after procedure. One perforation resulted from stent malpositioning, the others were associated with tumor necrosis. Two cases of peritonitis resulted in death, mortality – 2%. Long-term complications included recurrence of obstructive symptoms (2) due to stent occlusion (tumor ingrowth, 449 and 633 days after stenting) and rectal bleeding (1). Median survival was 133 days.

Conclusions:

Stenting is an effective method of palliation for patients with malignant colorectal obstruction, including stenoses in the right colon. The main early complication in cases of locally advanced cancer is bowel perforation, which can be diminished by strict observance of stenting techniques. Placement of covered stents is associated with an increased risk of migration.