The efficacy of self-expanding metal stents for malignant colorectal obstruction by noncolonic malignancy with peritoneal carcinomatosis

Dis Colon Rectum. 2013 Nov;56(11):1228-32. doi: 10.1097/DCR.0b013e3182a411e7.

Abstract

Background: Although self-expanding metal stents for colorectal obstruction is preferred over emergency surgery, the efficacy of self-expanding metal stents in patients with malignant colorectal obstruction by a noncolonic malignancy with peritoneal carcinomatosis has not been demonstrated.

Objective: The aim of this study was to evaluate the survival and long-term clinical outcome of self-expanding metal stents as the initial interventional approach in patients with malignant colorectal obstruction due to a noncolonic malignancy with peritoneal carcinomatosis.

Design: This is a retrospective study.

Settings: This study was conducted at 2 tertiary care academic medical centers in South Korea.

Patients: The patients were included who underwent self-expanding metal stent insertion for palliation of a malignant colorectal obstruction by a noncolonic malignancy with peritoneal carcinomatosis between July 2004 and January 2010. Inclusion criteria were incurable status, noncolorectal cancer, obstructive symptoms and/or signs, and colonoscopic findings of obstruction.

Main outcome measures: The survival and success rate of patients undergoing self-expanding metal stents insertion was assessed.

Results: Twenty patients were included during the study period. Technical success of self-expanding metal stents was achieved in 18/20 (90.0%) patients, and obstructive symptoms were resolved within 72 hours in 17/20 (85.0%) patients. Ten patients (10/20, 50%) did not need further intervention during the follow-up period after the first stent insertion. Eight patients ultimately underwent surgery during the follow-up period. One of the remaining 2 patients underwent additional endoscopic treatment without surgery. Another patient refused further intervention and thus received conservative management. Mean event-free survival was 119.0 days, and the mean overall survival of the included patients was 156.3 days.

Limitation: The number of study patients was small.

Conclusion: Self-expanding metal stent insertion appears to be a reasonable first-treatment option in patients with malignant colorectal obstruction by noncolonic malignancy with peritoneal carcinomatosis.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma / secondary*
  • Colonic Diseases / therapy*
  • Female
  • Humans
  • Intestinal Obstruction / therapy*
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / pathology
  • Palliative Care
  • Peritoneal Neoplasms / secondary*
  • Rectal Diseases / therapy*
  • Reoperation
  • Retrospective Studies
  • Stents*