Brief Article
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World J Gastroenterol. Feb 21, 2013; 19(7): 1119-1123
Published online Feb 21, 2013. doi: 10.3748/wjg.v19.i7.1119
A temporary self-expanding metallic stent for malignant colorectal obstruction
Xiao-Li Ding, Yong-Dong Li, Rui-Min Yang, Fen-Bao Li, Ming-Qiu Zhang
Xiao-Li Ding, Yong-Dong Li, Rui-Min Yang, Fen-Bao Li, Ming-Qiu Zhang, Department of Imaging and Interventional Center, The First Affiliated Hospital of Xinxiang Medical College, Weihui 453100, Henan Province, China
Yong-Dong Li, Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
Author contributions: Yang RM, Li FB and Zhang MQ performed the majority of experiments; Li YD and Yang RM provided vital reagents and analytical tools and were also involved in revising the manuscript; Yang RM collected all the human materials and provided financial support for this work; Ding CL designed the study and wrote the manuscript.
Supported by National Science Technology Pillar Program in the 11th Five-Year Plan, No. 2008BAI59B03; and Research Special Fund for the Public Welfare Industry of Health, No. 201202004
Correspondence to: Dr. Rui-Min Yang, MD, Professor, Department of Imaging and Interventional Center, The First Affiliated Hospital of Xinxiang Medical College, No. 88, Jian Kang Road, Weihui 453100, Henan Province, China. y_rmin@163.com
Telephone: +86-373-4402942 Fax: +86-373-4402573
Received: December 6, 2012
Revised: January 17, 2013
Accepted: January 23, 2013
Published online: February 21, 2013
Processing time: 77 Days and 23 Hours
Abstract

AIM: To investigate the clinical safety and efficacy of a temporary self-expanding metallic stent (SEMS) for malignant colorectal obstruction.

METHODS: From September 2007 to June 2012, 33 patients with malignant colorectal obstruction were treated with a temporary SEMS. The stent had a tubular configuration with a retrieval lasso attached inside the proximal end of the stent to facilitate its removal. The SEMS was removed one week after placement. Clinical examination, abdominal X-ray and a contrast study were prospectively performed and both initial and follow-up data before and at 1 d, 1 wk, and 1 mo, 3 mo, 6 mo and 12 mo after stent placement were obtained. Data collected on the technical and clinical success of the procedures, complications, need for reinsertion and survival were analyzed.

RESULTS: Stent placement and removal were technically successful in all patients with no procedure-related complications. Post-procedural complications included stent migration (n = 2) and anal pain (n = 2). Clinical success was achieved in 31 (93.9%) of 33 patients with resolution of bowel obstruction within 3 d of stent removal. Eleven of the 33 patients died 73.81 ± 23.66 d (range 42-121 d) after removal of the stent without colonic re-obstruction. Clinical success was achieved in another 8 patients without symptoms of obstruction during the follow-up period. Reinsertion of the stent was performed in the remaining 12 patients with re-obstruction after 84.33 ± 51.80 d of follow-up. The mean and median periods of relief of obstructive symptoms were 97.25 ± 9.56 d and 105 ± 17.43 d, respectively, using Kaplan-Meier analysis.

CONCLUSION: Temporary SEMS is a safe and effective approach in patients with malignant colorectal obstruction due to low complication rates and good medium-term outcomes.

Keywords: Self-expanding metallic stents; Colorectum; Malignant obstruction; Complications