Clinical outcomes of colorectal stenting

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OBJECTIVE

The aim of retrospective study was to evaluate early and long-term outcomes of colorectal stenting.

MATERIAL AND METHODS

101 patients presenting with symptomatic colorectal obstruction at the period of 2010—2020 underwent an attempt of stenting. Stenosis due to colorectal cancer (92) or extracolonic malignancies (9) was located in left half of large bowel in 85 patients (rectum and rectosigmoid — 43, left colon — 42), in right colon — in 16 patients. Effectiveness of stent placement, adverse events and survival were analyzed.

RESULTS

Technical and functional success of stenting was achieved in 99 patients (98%). Attempt of stent placement failed in 2 cases of ascending colon cancer, technical success in right colon — 88%. Early complications were observed in 8 patients (7.9%): colonic perforation with peritonitis (3), extraperitoneal rectal perforation (1), pelvic abscess in combination with stent dislocation (1), and distal migration of covered stents (3). 3 perforations at the tumor site occurred on the first-second days, one was delayed and revealed on the 11th day after procedure. Two cases of peritonitis resulted in death, stent-associated mortality — 2%. 3 patients underwent radical resections. Recurrence of obstructive symptoms due to stent occlusion in 8—20 months after palliative stenting occurred in 4 patients.

CONCLUSION

Stenting is a valid technique to treat malignant colorectal obstruction. The main complication in cases of locally advanced cancer is bowel perforation. Placement of covered stents is associated with an increased risk of migration.

Keywords:

colorectal stenting

self-expandable metal stents

SEMS

colorectal cancer

large bowel obstruction

Authors:

Davydova S.V.

Peoples' Friendship University of Russia named after Patrice Lumumba

ORCID: 0000-0002-4979-0264

Fedorov A.G.

Peoples' Friendship University of Russia named after Patrice Lumumba

ORCID: 0000-0002-4562-9481

Yun O.A.

Buyanov Moscow City Clinical Hospital

ORCID: 0000-0002-4548-7321

Klimov A.E.

Peoples' Friendship University of Russia named after Patrice Lumumba

ORCID: 0000-0002-1397-9540

Received:

07.12.2022

Accepted:

24.01.2023

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