Radiology, Vol 209, 117-120, Copyright © 1998 by Radiological Society of North America

ARTICLES

Acute colorectal obstruction: stent placement for palliative treatment-- results of a multicenter study

MA de Gregorio, A Mainar, E Tejero, R Tobio, E Alfonso, I Pinto, R Fernandez, M Herrera and JA Fernandez
Interventional Radiology Section, Hospital Clinico Universitario, C/San Juan Bosco, Zaragoza, Spain.

PURPOSE: To evaluate the usefulness of stent implantation as a palliative treatment in patients with acute colonic obstruction who are not surgical candidates. MATERIALS AND METHODS: Twenty-four patients (eight women, 16 men; age range, 60-98 years) with acute colonic obstruction underwent colonic stent placement. In nine patients, the procedure was considered a primary palliative treatment; seven patients had a previous diagnosis of disseminated neoplastic disease, and two were not surgical candidates because of their poor general condition. In the remaining 15 patients, stent placement was considered the definitive palliative treatment after tumor staging. The mean time of follow-up was 8.4 months (range, 1-24 months) for patients who lived and 6.3 months (range, 1-12 months) for those who died. RESULTS: Stent placement was successful in all patients. Clinical and radiographic findings of bowel obstruction resolved within 24 hours after stent placement in 23 (96%) patients. None of the patients required colostomy for bowel decompression after immediate stent placement. Complications developed in 10 (42%) patients: Two (8%) patients had mild rectal bleeding; three (12%), abdominal pain; two (8%), malpositioning of the stent; two (8%), pseudo-obstructive episodes due to fecal impaction; and one (4%), occlusive tumor ingrowth into the stent lumen. One (4%) patient underwent surgery to resolve stent malfunction due to poor positioning. Two (8.3%) patients--one with malpositioning of the prosthesis and the other with stent occlusion--required a new stent. The remaining complications required no further treatment. The mortality rate at 6 months was 24%. Eight patients were alive at the time this article was written. CONCLUSION: Colorectal stent placement resulted in successful palliation of acute colonic obstruction in patients with disseminated neoplastic disease.

This article has been cited by other articles:

				M. Karoui, A. Charachon, C. Delbaldo, J. Loriau, A. Laurent, I. Sobhani, J. Tran Van Nhieu, J. C. Delchier, P.-L. Fagniez, P. Piedbois, et al. Stents for Palliation of Obstructive Metastatic Colon Cancer: Impact on Management and Chemotherapy Administration Arch Surg, July 1, 2007; 142(7): 619 - 623. [Abstract] [Full Text] [PDF]

				R Lewis, A Flynn, M E Dean, A Melville, A Eastwood, and A Booth Management of colorectal cancers Qual. Saf. Health Care, October 1, 2004; 13(5): 400 - 404. [Abstract] [Full Text] [PDF]

				C. E. Dauphine, P. Tan, R. W. Beart Jr., P. Vukasin, H. Cohen, and M. L. Corman Placement of Self-Expanding Metal Stents for Acute Malignant Large-Bowel Obstruction: A Collective Review Ann. Surg. Oncol., July 1, 2002; 9(6): 574 - 579. [Abstract] [Full Text] [PDF]

				L. Paul, I. Pinto, H. Gomez, R. Fernandez-Lobato, and E. Moyano Metallic Stents in the Treatment of Benign Diseases of the Colon: Preliminary Experience in 10 Cases Radiology, June 1, 2002; 223(3): 715 - 722. [Abstract] [Full Text] [PDF]

				T. H. Baron Expandable Metal Stents for the Treatment of Cancerous Obstruction of the Gastrointestinal Tract N. Engl. J. Med., May 31, 2001; 344(22): 1681 - 1687. [Full Text] [PDF]

				F. Camúñez, A. Echenagusia, G. Simó, F. Turégano, J. Vázquez, and I. Barreiro-Meiro Malignant Colorectal Obstruction Treated by Means of Self-expanding Metallic Stents: Effectiveness before Surgery and in Palliation Radiology, August 1, 2000; 216(2): 492 - 497. [Abstract] [Full Text]

				T. E. Velling, L. D. Hall, and F. J. Brennan Colonic Stent Placement Facilitated by Percutaneous Cecostomy and Antegrade Enema Am. J. Roentgenol., July 1, 2000; 175(1): 119 - 120. [Full Text] [PDF]

				M. A. Mauro, R. E. Koehler, and T. H. Baron Advances in Gastrointestinal Intervention: The Treatment of Gastroduodenal and Colorectal Obstructions with Metallic Stents Radiology, June 1, 2000; 215(3): 659 - 669. [Abstract] [Full Text]

				A. Mainar, M. A. De Gregorio Ariza, E. Tejero, R. Tobío, E. Alfonso, I. Pinto, M. Herrera, and J. A. Fernández Acute Colorectal Obstruction: Treatment with Self-expandable Metallic Stents before Scheduled Surgery—Results of a Multicenter Study Radiology, January 1, 1999; 210(1): 65 - 69. [Abstract] [Full Text]