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Vascular and Interventional Radiology |
1 Radiology Service, Hospital Central del Insalud de Soria, Spain (A.M.)
2 Departments of Interventional Radiology (M.A.D.G.A., E.A., J.A.F.)
3 Surgery (E.T.), Hospital Clínico Universitario de Zaragoza, San Juan Bosco 15, 50-009 Zaragoza, Spain
4 Interventional Radiology Section, Hospital Uiversitario de Getafe, Madrid, Spain (I.P.)
5 Interventional Radiology Section, Clínica La Zarzuela, Madrid, Spain (R.T.)
6 Radiology Service, Louisiana State University Medical Center, New Orleans (M.H.).
PURPOSE: To evaluate the efficacy of treatment with self-expandable metallic stents for acute colonic obstruction before elective surgical resection.
MATERIALS AND METHODS: In 71 patients with malignant obstruction seen from October 1993 through December 1996, lesions were located in the transverse colon in one patient, in the descending colon in 22 patients, and in the rectosigmoid region in 48. A total of 72 self-expandable metallic stents were implanted within 24 hours of diagnosis.
RESULTS: Technical success was obtained in 64 patients (90%). In two cases (3%), it was not possible to advance across the obstructing mass. In five cases (7%), the prostheses were poorly positioned at the site of obstruction, requiring placement of a new stent in three cases. Clinical improvement and resolution of the obstruction were confirmed in 66 patients (93%) within 96 hours. Minor complications developed in nine cases (13%). One patient (1%) underwent surgery to resolve a colonic perforation caused by wires at the ends of the stent. The mean time between stent placement and surgery was 8.6 days (range, 6–16 days).
CONCLUSION: Implantation of colorectal stents is a safe treatment of acute malignant colonic obstruction before resection.
Index terms: Colon, interventional procedure, 75.1299 • Colon, neoplasms, 75.31, 75.32, 75.33 • Colon, stenosis or obstruction, 75.31, 75.32, 75.33 • Stents and prostheses, 755.1299, 756.1299
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