Syn, W.-K.; Ahmed, M.M.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA94
Academic Journal
Introduction: There has been an expansion in the use of metallic stents in the management of large bowel obstruction. Aims: To evaluate results of colonic stent placement in our centre. Methods: We reviewed all patients who underwent colonic stent placement at our hospital between March 2000 and August 2002. Stenting was performed under fluoroscopic and endoscopic guidance. Enteral Wallstents (6 cm or 9 cm long × 20-22 mm diameter, uncovered, Boston Scientific) were used in the majority. All patients had intravenous midazolam (mean dose 4.7 mg). Results: There were 13 patients (7 female, mean age 74.4 years, range: 42-92 year) undergoing 14 procedures. All patients presented with large bowel obstruction. The sites of obstruction were rectum (n = 1), rectosigmoid (n = 9), descending colon (n = 2), and ascending colon (n = 1). 9/13 patients had adenocarcinoma, the others had colonic obstruction due to ovarian cancer (2), Non-Hodgkins Lymphoma (1), and diverticular stricture (1). The mean length of the obstructing lesion was 6.2 cm (range 3-14.5 cm). Technical success was achieved in 12 stenting attempts. One patient had 2 stents placed simultaneously for a long rectosigmoid tumour, another had 2 successive stents (3 months apart) for recurrent tumour. Of these 12 technical successes, 10 had sustained clinical and radiological improvement. One patient had early bleeding (requiring transfusion) and subsequent stent migration. 6/13 patients also underwent adjuvant chemoradiotherapy. In the 10 patients with technical and clinical success, stenting was the definitive palliative procedure. The length of hospital stay was 1-5 days. Mean survival was 128 days in those who received adjuvant chemoradiotherapy and 40 days in those who did not. The remaining 4 with technical or clinical failure underwent emergency surgical decompression. Conclusion: Metallic stents are effective, safe and minimise hospital stay. Stenting obviates the need for emergency surgery in a...


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