Tertiary Care Center Trends in Colonic Stent Placement over the Past Decade

Wassem Y Juakiem; Kelita Singh; Andrew Ofosu; Daryl Ramai; Alana Persaud; James H Tabibian; Eduardo Rodrigues-Pinto; Mohit Girotra; Monique T Barakat

doi:10.3390/cancers16193309

Tertiary Care Center Trends in Colonic Stent Placement over the Past Decade

Cancers (Basel). 2024 Sep 27;16(19):3309. doi: 10.3390/cancers16193309.

Authors

Wassem Y Juakiem¹, Kelita Singh¹, Andrew Ofosu¹, Daryl Ramai², Alana Persaud³, James H Tabibian^{4

5}, Eduardo Rodrigues-Pinto⁶, Mohit Girotra⁷, Monique T Barakat^{1

8

9}

Affiliations

¹ Division of Gastroenterology, Stanford University, Stanford, CA 94305, USA.
² Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA 02115, USA.
³ Division of Gastroenterology and Hepatology, SUNY Downstate, Brooklyn, NY 11203, USA.
⁴ Adventist Health Glendale, Glendale, CA 91206, USA.
⁵ David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
⁶ Division of Gastroenterology, Centro Hospitalar São João, Porto, Portugal.
⁷ Digestive Health Institute, Swedish Medical Center, Seattle, WA 98104, USA.
⁸ Division of Pediatric Gastroenterology, Lucille Packard Children's Hospital, Stanford University Medical Center, Palo Alto, CA 94305, USA.
⁹ Medicine and Pediatrics, Divisions of Adult/Pediatric Gastroenterology & Hepatology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305, USA.

Abstract

Introduction: Colonic endoluminal stent placement is a commonly utilized and effective endoscopic approach for the management of malignant large bowel obstruction and is an emerging approach for the management of some benign etiologies of large bowel obstruction. However, recent studies evaluating the evolution of clinical scenarios and patient populations for which stenting is performed in real-world practice are lacking.

Methods: We assessed colonic stent utilization patterns in a tertiary care academic medical center over the past 10 years. We analyzed the demographics and patient and procedure characteristics of the initial (first half of study period) and latter (second half of the study period) procedures to assess trends over time using standard descriptive statistics.

Results: Our analysis was notable due to its provision of some novel insights. The frequency of colonic stent placement procedures increased significantly over time by comparison of the procedure volume for the initial 5-year interval (22 colonic stent procedures) relative to the latter 5-year interval (49 colonic stent procedures) (p = 0.03). The median age of patients who underwent colonic stent placement was significantly lower in the latter 5 years, compared with the initial 5 years of the study period (mean of 81.41 vs. 58.73 years, respectively, p < 0.001). The increased diversity of indications for colonic stent placement was also noted over time.

Conclusions: Our data highlight the evolution of colonic stent placement in tertiary care practice over time and are notable for some interesting trends, including the increased utilization of colonic stent placement over time, the broadening of indications for colonic stent placement to include benign indications, and lower patient age at the time of colonic stent placement over time. These findings will help inform the clinical practice of colonic stent placement and provide a foundation to guide future research on the topic.

Keywords: benign obstruction; colonic stent; malignant obstruction.

Grants and funding

This research received no external funding.