Erschienen in:
01.07.2004 | Original Contribution
Colorectal Stenting for Malignant and Benign Disease: Outcomes in Colorectal Stenting
verfasst von:
Noriko Suzuki, M.D., Brian P. Saunders, M.D., Siwan Thomas-Gibson, M.R.C.P., Charles Akle, F.R.C.S., Michele Marshall, F.R.C.R., Steve Halligan, F.R.C.R.
Erschienen in:
Diseases of the Colon & Rectum
|
Ausgabe 7/2004
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INTRODUCTION:
Self-expanding metal stents are now an established treatment for malignant colonic obstruction. Favorable outcomes have been reported both for cancer palliation and treatment of acute obstruction as a “bridge” to surgery. However, little data exists regarding the use of stents for benign colonic obstruction.
METHODS:
All cases of colonic stent insertion occurring between December 1996 to October 2002 were reviewed. During the study period, 36 patients with malignant obstruction and 6 patients with benign obstructive disease underwent placement of self-expandable stents using a combined endoscopic and fluoroscopic technique.
RESULTS:
Stent placement was successful in 36 of 42 patients (86 percent). Complications occurred in 16 of 36 patients (44 percent): migration (n = 7), reobstruction (n = 5), perforation (n = 2), fistula formation (n = 1), and stent fracture (n = 1). Stent placement was successful in 100 percent of patients with benign strictures but poststent migration was frequent (2/6).
CONCLUSIONS:
Stent insertion provided an effective outcome in patients with malignant colonic obstruction as a palliative and preoperative therapy. Although a relatively high migration rate was observed in patients with benign strictures, stenting was still effective in providing luminal patency (median follow-up, 7.5 months). Stenting should be considered as a first-line treatment for malignant strictures and as a potential therapy for selected benign strictures.