The Efficacy of Metallic Stent Placement in the Treatment of Colorectal Obstruction

Sung Gwon Kang, Gyu Sik Jung, Soon Gu Cho, Jae Gyu Kim, Joo Hyung Oh, Ho Young Song, Eun Sang Kim

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Objective: To evaluate the efficacy of newly designed covered and non-covered coated colorectal stents for colonic decompression. Materials and Methods: Twenty-six patients, (15 palliative cases and 11 preoperative) underwent treatment for the relief of colorectal obstruction using metallic stents positioned under fluoroscopic guidance. In 24 of the 26, primary colorectal carcinoma was diagnosed, and in the remaining two, recurrent colorectal carcinoma. Twenty-one patients were randomly selected to receive either a type A or type B stent; for the remaining five, type C was used. Type A, an uncovered nitinol wire stent, was lightly coated to ensure structural integrity. Type B (flare type) and C (shoulder type) stents were polyurethane covered and their diameter was 24 and 26mm, respectively. The rates of technical success, clinical success, and complications were analyzed using the chi-square test, and to analyse the mean period of patency, the Kaplan-Meier method was used. Results: Thirty of 31 attempted placements in 26 patients were successful, with a technical success rate of 96.8% (30/31) and a clinical success rate of 80.0% (24/30). After clinically successful stent placement, bowel decompression occurred within 1-4 (mean, 1.58±0.9) days. Five of six clinical failures involved stent migration and one stent did not expand after successful placement. In the preoperative group, 11 stents, one of which migrated, were placed in ten patients, in all of whom bowel preparation was successful. In the palliative group, 19 stents were placed in 15 patients. The mean period of patency was 96.25±105.12 days: 146.25±112.93 for type-A, 78.82±112.26 for type-B, and 94.25±84.21 for type-C. Complications associated with this procedure were migration (n=6, 20%), pain (n=4, 13.3%), minor bleeding (n=5, 16.7%), incomplete expansion (n=1, 3.3%), and tumor ingrowth (n=1, 3.3%). The migration rate was significantly higher in the type-B group than in other groups (p=0.038). Conclusion: Newly designed covered and non-covered metallic stents of a larger diameter are effective for the treatment of colorectal obstruction. The migration rate of covered stents with flaring is higher than that of other types. For evaluation of the ideal stent configuration for the relief of colorectal obstruction, a clinical study involving a larger patient group is warranted.

Original languageEnglish (US)
Pages (from-to)79-86
Number of pages8
JournalKorean Journal of Radiology
Volume3
Issue number2
DOIs
StatePublished - 2002
Externally publishedYes

Keywords

  • Colon, interventional procedure
  • Colon, neoplasm
  • Colon, stenosis or obstruction
  • Stents and orostheses

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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