Feasibility and Safety of Emergency Self-Expandable Metal Stenting (Sems) in Patients With Malignant Colonic Obstruction– a Russian Singlecenter Experience

Aims Self-expanding metal stents (SEMSs) can be used as a palliative treatment or to initially decompress colon prior to definitive surgery (as a so-called ‘bridge to surgery’). The purpose of this study was to investigate the technical and clinical efficacy and safety of SEMS used as bridge to surgery for malignant large bowel obstruction.

Methods A unicentric retrospective study was conducted at University Clinic №2 of Sechenov First Moscow State Medical University (Sechenov University) from August 2016 to December 2019. Stenting procedures were performed on 61 patients with a mean age of 65 years (range, 45-89 years old) for relief of obstruction. Prior to the stent placement, the colon was cleansed per enema. 33 patients (54 %) were underwent procedure under propofol sedation. In all patients 65 uncovered SEMS were inserted endoscopically under endoscopic and fluoroscopic monitoring. A review was conducted to determine the effectiveness of the procedure and the short- and long-term complications.

Results Stent placement was technically and clinically successful in 61/60 (98,4 %). 30 patients (49,2 %) underwent SEMS insertion as a bridge to surgery, 31 patients for palliation. The follow-up period was 9 months. In one case the stent placement was failed due to impossibility of passing guide catheter through the stenosis. Perforation or bleeding were not observed in the study. Tenesmus was the most common complication, noted in 15 (24,6 %%) patients, pain (2-3 score VAS) was observed in 5 (8,2 %) patients, distal stent migration was not registered. Malignant bowel re-obstruction occurred in 4 (6,6 %) patients required re-stenting by stent-in-stent method in 9 months of follow-up.

Conclusions Stent placement for colorectal obstruction is an effective and relatively safe procedure, with minor complication. It not only allows subsequent resection, but is also definitive for palliative treatment in patients with obstructive colorectal cancer.

Citation:Kiryukhin A, Pavlov P, Gorovaya I. eP277 FEASIBILITY AND SAFETY OF EMERGENCY SELF-EXPANDABLE METAL STENTING (SEMS) IN PATIENTS WITH MALIGNANT COLONIC OBSTRUCTION– A RUSSIAN SINGLECENTER EXPERIENCE. Endoscopy 2021; 53: S189.

Publication History

Article published online:
19 March 2021