Digestion

Original Paper

Outcomes of Secondary Self-Expandable Metal Stents versus Surgery after Delayed Initial Palliative Stent Failure in Malignant Colorectal Obstruction

Yoon J.Y.a · Park S.J.a · Hong S.P.a · Kim T.I.a · Kim W.H.a, b · Cheon J.H.a, b

Author affiliations

aDepartment of Internal Medicine and Institute of Gastroenterology, and bBrain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea

Keywords: Stent failureSecondary stentPalliative surgeryColorectal obstruction

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Digestion 2013;88:46-55
https://doi.org/10.1159/000351208

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 28, 2012
Accepted: April 09, 2013
Published online: July 19, 2013
Issue release date: July 2013

Number of Print Pages: 10
Number of Figures: 4
Number of Tables: 6

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

Abstract

Background/Aims: When re-intervention is required due to an occluded first colorectal self-expanding metal stent for malignant colorectal obstruction, serious controversies exist regarding whether to use endoscopic re-stenting or surgery. To compare the clinical outcomes in patients who underwent stent re-insertion versus palliative surgery as a second intervention. Methods: A total of 115 patients who received either self-expandable metal stent (SEMS) insertion or palliative surgery for treatment of a second occurrence of malignant colorectal obstruction after the first SEMS placement were retrospectively studied between July 2005 and December 2009. Results: The median overall survival (8.2 vs. 15.5 months) and progression-free survival (4.0 vs. 2.7 months) were not significantly different between the stent and surgery groups (p = 0.895 and 0.650, respectively). The median lumen patency in the stent group was 3.4 months and that in the surgery group was 7.9 months (p = 0.003). The immediate complication rate after second stent insertion was 13.9% and late complication rate was observed in 12 of 79 (15.2%) patients. There was no mortality related to the SEMS procedure. The complication and mortality rates associated with palliative surgery were 3.5% (2/57) and 12.3% (7/57), respectively. Conclusions: Although there is no significant difference in the overall survival between stenting and surgery, a secondary stent insertion had a lower mortality rate despite a shorter duration of temporary colorectal decompression compared to that of palliative surgery.

© 2013 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 28, 2012
Accepted: April 09, 2013
Published online: July 19, 2013
Issue release date: July 2013

Number of Print Pages: 10
Number of Figures: 4
Number of Tables: 6

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

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2013, Vol.88, No. 1

July 2013

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