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Background . Self-expanding metal stents can alleviate malignant colonic obstruction in incurable patients and avoid palliative stoma surgery.  Objective . Evaluate stent effectiveness and safety on palliation of patients with malignant colorectal strictures.  Design . Two prospective, one Spanish and one global, multicenter studies.  Settings . 39 centers (22 academic, 17 community hospitals) from 13 countries.  Patients . A total of 257 patients were enrolled, and 255 patients were treated with a WallFlex uncovered enteral colonic stent. Follow-up was up to 12 months or until death or retreatment.  Interventions(s) . Self-expanding metal stent placement.  Main Outcome Measures . Procedural success, clinical success, and safety.  Results . Procedural success was 98.4% (251). Clinical success rates were 87.8% at 30 days, 89.7% at 3 months, 92.8% at 6 months, and 96% at 12 months. Overall perforation rate was 5.1%. Overall migration rate was 5.5%. Overall death rate during follow-up was 48.6% (124), with 67.7% of deaths related to the patient's colorectal cancer, unrelated in 32.3%. Only 2 deaths were related to the stent or procedure.  Limitations . No control group.  Conclusions . The primary palliative option for patients with malignant colonic obstruction should be self-expanding metal stent placement due to high rates of technical success and efficacy in symptom palliation and few complications.

gastroenterology research and practice

Self-Expanding Metal Stenting for Palliation of Patients with Malignant Colonic Obstruction: Effectiveness and Efficacy on 255 Patients with 12-Month's Follow-up