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Short- and long-term clinical outcomes of self-expandable metal stents inserted for colorectal obstruction and efficacy of different insertion techniques.
Gargallo, Carla J; Ferrandez, Angel; Carrera, Patricia; Simon, Miguel Angel; Ducons, Julio; Lanas, Angel.
Afiliación
  • Gargallo CJ; Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (ISS Aragón), Zaragoza, Spain. Electronic address: carlajerusalen@hotmail.com.
  • Ferrandez A; Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (ISS Aragón), Zaragoza, Spain.
  • Carrera P; CIBER Enfermedades Hepáticas y digestivas (CIBERehd), Spain.
  • Simon MA; Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Universidad de Zaragoza, Zaragoza, Spain.
  • Ducons J; Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
  • Lanas A; Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (ISS Aragón), Zaragoza, Spain; CIBER Enfermedades Hepáticas y digestivas (CIBERehd), Spain; Universidad de Zaragoza, Zaragoza, Spain.
Gastroenterol Hepatol ; 42(3): 157-163, 2019 Mar.
Article en En, Es | MEDLINE | ID: mdl-30314765
OBJECTIVES: (1) To evaluate the short- and long-term clinical outcomes of patients after colorectal stent placement and (2) to assess the safety and efficacy of the stents for the resolution of colorectal obstruction according to the insertion technique. METHODS: Retrospective cohort study which included 177 patients with colonic obstruction who underwent insertion of a stent. RESULTS: A total of 196 stents were implanted in 177 patients. Overall, the most common cause of obstruction was colorectal cancer (89.3%). Ninety-two stents (47%) were placed by radiologic technique and 104 (53%) by endoscopy under fluoroscopic guidance. Technical success rates were 95% in both groups. Clinical success rates were 77% in the radiological group and 81% in the endoscopic group (p>0.05). The rate of complications was higher in the radiologic group compared with the endoscopic group (38% vs 20%, respectively; p=0.006). Among patients with colorectal cancer (158), 65 stents were placed for palliation but 30% eventually required surgery. The multivariate analysis identified three factors associated with poorer long-term survival: tumor stage IV, comorbidity and onset of complications. CONCLUSIONS: Stents may be an alternative to emergency surgery in colorectal obstruction, but the clinical outcome depends on the tumor stage, comorbidity and stent complications. The rate of definitive palliative stent placement was high; although surgery was eventually required in 30%. Our study suggests that the endoscopic method of stent placement is safer than the radiologic method.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Enfermedades del Recto / Enfermedades del Colon / Implantación de Prótesis / Stents Metálicos Autoexpandibles / Obstrucción Intestinal Tipo de estudio: Etiology_studies / Evaluation_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En / Es Revista: Gastroenterol Hepatol Año: 2019 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Enfermedades del Recto / Enfermedades del Colon / Implantación de Prótesis / Stents Metálicos Autoexpandibles / Obstrucción Intestinal Tipo de estudio: Etiology_studies / Evaluation_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En / Es Revista: Gastroenterol Hepatol Año: 2019 Tipo del documento: Article