Year 2015 / Volume 107 / Number 9
Original
Outcome of endoscopic self-expandable metal stents in acute malignant colorectal obstruction at a tertiary center

534-538

DOI: 10.17235/reed.2015.3785/2015

Eduardo Rodrigues-Pinto, Pedro Pereira, Susana Lopes, Armando Ribeiro, Pedro Moutinho-Ribeiro, Armando Peixoto, Guilherme Macedo,

Abstract
Background: Malignant colorectal obstruction (MCRO) by advanced colonic cancer occurs in 8–13% of colonic cancer patients. Emergent surgery carries a high mortality and morbidity risk. Endoscopic self-expanding metal stents (SEMS) may be used in acute MCRO. Aim: Evaluate clinical outcome of SEMS in acute MCRO and efficacy of SEMS placement considering fluoroscopy guidance. Methods: Retrospective study of patients with acute MCRO that placed SEMS in a 3 years period. Results: SEMS were placed in 47 patients, followed-up for a median time of 150 days. The intent of stenting was bridge to definitive surgery in 40% of the patients (n=19) and palliation in the remaining 60% (n=28). The location of the tumor did not influence the presence of lymph node involvement (p=0.764) nor metastasis (p=0.885). Mortality rate at year 1 was 61%. Survival was significantly higher in patients submitted later to combination therapy compared to chemotherapy, surgery or symptomatic treatment (p<0.001). Fluoroscopy was used in 57% of the procedures. Clinical success was 79%. A second SEMS was needed during the procedure in 6% of the patients. Rate of early and late complications was 11% and 5%, respectively. Fluoroscopy guidance did not influence the occurrence of immediate (p=0.385), early (p=0.950) or late complications (p=0.057). Thirty-three percent of patients underwent surgery at a later stage, with neo-adjuvant therapy in 18%. Conclusions: SEMS provide a relative safe and successful treatment in a palliative or bridge-to-surgery indication. No significant differences were found in SEMS placement success, early complications or late complications considering fluoroscopy guidance.
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References
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Rodrigues-Pinto E, Pereira P, Lopes S, Ribeiro A, Moutinho-Ribeiro P, Peixoto A, et all. Outcome of endoscopic self-expandable metal stents in acute malignant colorectal obstruction at a tertiary center. 3785/2015


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Publication history

Received: 22/03/2015

Accepted: 25/04/2015

Online First: 11/06/2015

Published: 29/08/2015

Article revision time: 32 days

Article Online First time: 81 days

Article editing time: 160 days


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