2022 Volume 64 Issue 8 Pages 1448-1456
Background and aim: Self-expanding metallic stents (SEMSs) have been available for use in Japan since January 2012. SEMS placement is performed as a bridge to surgery (BTS) or as a palliative treatment; however, only a few reports have been published about this method. The aim of this study was to clarify the efficacy and complications of SEMS placement for malignant colorectal obstruction.
Methods: From January 2012 to March 2021, SEMS placement was attempted in 180 patients with symptomatic colorectal obstruction. We retrospectively evaluated the efficacy and complications of SEMS placement performed at our institution.
Results: Technical success was achieved in 176 patients (97.8%), and clinical success was achieved in 165 patients (91.7%). A SEMS was placed as a BTS in 94 patients and for palliation in 86 patients. Four patients in the palliation group died within 24 h after SEMS placement. The main complications associated with SEMS placement were stent occlusion in 20 patients (11.4%, 20/176), bowel perforation in 11 patients (6.1%, 11/180), and stent migration in 4 patients (2.3%, 4/176). In the BTS group, bowel perforation was observed in two patients (2.1%, 2/94), one of whom required emergency surgery. In the palliation group, the median SEMS patency time was 221 days and the median patient survival time was 154 days.
Conclusion: SEMS placement is a relatively safe and effective method for managing malignant colorectal obstruction.
