Premium
Outcomes of endoluminal stenting for distal colorectal cancer: An institutional experience
Author(s) -
Wong James C.H.,
Cheung Hester Y.S.,
Yau KwokKay,
Chung ChiChiu,
Li Michael K.W.
Publication year - 2009
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/j.1744-1633.2008.00428.x
Subject(s) - medicine , colorectal cancer , stent , surgery , endoscopic stenting , cancer , radiology
Aim: The present article aims to review the results of the use of the self‐expanding metallic stent (SEMS) in our institution for distal colorectal tumours, defined as tumours distal to the splenic flexure. Patients and methods: SEMS was selectively offered to the following patients with distal colorectal tumours: (i) patients with clinically obstructed tumours; (ii) patients undergoing palliative treatment; and (iii) patients planned for neoadjuvant chemotherapy. All data, including outcomes and complications, were entered prospectively into a database. A review was carried out for those patients who underwent endoluminal stenting between February 2002 and August 2008. Results: Sixty‐eight patients were evaluated with a median age of 68 years (range 39–91). The median follow up was 11 months. Of these, 53 patients received emergency stenting for acute intestinal obstruction, 12 had palliative stenting for endoscopically obstructive cancer and three had pre‐emptive stenting of locally advanced, stenotic rectal cancer before neoadjuvant chemo‐irradiation. The overall technical success and clinical success rates were 81% and 65%, respectively. Complications included four stent‐related perforations (5.9%) and seven distal migrations (10.3%). Twenty‐seven patients from the intestinal obstruction group and the three patients from the neoadjuvant chemo‐irradiation group subsequently underwent laparoscopic tumour resection with success. Conclusion: In conclusion, our experience showed that SEMS is a useful adjunct in the management of distal colorectal cancer. Apart from being an alternative measure for palliation, SEMS is an effective and non‐invasive way for relieving obstruction in patients with obstructed tumours, allowing them to undergo subsequent one‐stage laparoscopic tumour resection. It is also useful in patients with locally advanced rectal cancer, in whom neoadjuvant chemo‐irradiation is planned.