Long-term outcome of palliative therapy for malignant colorectal obstruction in patients with unresectable metastatic colorectal cancers: Endoscopic stenting versus surgery

Hyun Jung Lee, Sung Pil Hong, Jae Hee Cheon, Tae Il Kim, Byung So Min, Nam Kyu Kim, Won Ho Kim

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Background: Self-expandable metal stents (SEMSs) provide a promising alternative for initial palliation of malignant bowel obstruction. However, data on the long-term outcomes of SEMSs are limited. Objective: The aim of this study was to compare the long-term outcomes of endoscopic stenting with those of surgery for palliation in patients with incurable obstructive colorectal cancer. Designs and Setting: A retrospective study. Patients: From January 2000 to December 2008, patients with incurable obstructive colorectal cancer who were treated with SEMSs (n = 71) or palliative surgery (n = 73) were reviewed. Interventions: SEMS placement by using through-the-endoscope methods or surgery. Main Outcome Measurements: Success rates and complication rates. Results: Early success rates in the SEMS group and those in the surgery group were not different (95.8% vs 100%, P = .12), and the SEMS group had fewer early complications than the surgery group (15.5% vs 32.9%, P = .015). Although the patency duration of the first stent in the SEMS group was shorter than that in the surgery group (P < .001), the median patency duration after a second stenting was comparable to that of the surgery group (P = .239). There were more late complications in the SEMS group than in the surgery group (P = .028), but the rates of major complications did not differ between the 2 groups (P = .074). Limitations: Retrospective and single-center study. Conclusions: SEMSs were not only an effective and acceptable therapy for initial palliation of malignant colorectal obstruction, but they also showed long-term efficacy comparable to that with surgery.

Original languageEnglish
Pages (from-to)535-542
Number of pages8
JournalGastrointestinal Endoscopy
Volume73
Issue number3
DOIs
Publication statusPublished - 2011 Mar 1

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Palliative Care
Colorectal Neoplasms
Self Expandable Metallic Stents
Endoscopes
Stents
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

@article{d17ba2aa2d2f4d069366d604677aa482,
title = "Long-term outcome of palliative therapy for malignant colorectal obstruction in patients with unresectable metastatic colorectal cancers: Endoscopic stenting versus surgery",
abstract = "Background: Self-expandable metal stents (SEMSs) provide a promising alternative for initial palliation of malignant bowel obstruction. However, data on the long-term outcomes of SEMSs are limited. Objective: The aim of this study was to compare the long-term outcomes of endoscopic stenting with those of surgery for palliation in patients with incurable obstructive colorectal cancer. Designs and Setting: A retrospective study. Patients: From January 2000 to December 2008, patients with incurable obstructive colorectal cancer who were treated with SEMSs (n = 71) or palliative surgery (n = 73) were reviewed. Interventions: SEMS placement by using through-the-endoscope methods or surgery. Main Outcome Measurements: Success rates and complication rates. Results: Early success rates in the SEMS group and those in the surgery group were not different (95.8{\%} vs 100{\%}, P = .12), and the SEMS group had fewer early complications than the surgery group (15.5{\%} vs 32.9{\%}, P = .015). Although the patency duration of the first stent in the SEMS group was shorter than that in the surgery group (P < .001), the median patency duration after a second stenting was comparable to that of the surgery group (P = .239). There were more late complications in the SEMS group than in the surgery group (P = .028), but the rates of major complications did not differ between the 2 groups (P = .074). Limitations: Retrospective and single-center study. Conclusions: SEMSs were not only an effective and acceptable therapy for initial palliation of malignant colorectal obstruction, but they also showed long-term efficacy comparable to that with surgery.",
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Long-term outcome of palliative therapy for malignant colorectal obstruction in patients with unresectable metastatic colorectal cancers : Endoscopic stenting versus surgery. / Lee, Hyun Jung; Hong, Sung Pil; Cheon, Jae Hee; Kim, Tae Il; Min, Byung So; Kim, Nam Kyu; Kim, Won Ho.

In: Gastrointestinal Endoscopy, Vol. 73, No. 3, 01.03.2011, p. 535-542.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term outcome of palliative therapy for malignant colorectal obstruction in patients with unresectable metastatic colorectal cancers

T2 - Endoscopic stenting versus surgery

AU - Lee, Hyun Jung

AU - Hong, Sung Pil

AU - Cheon, Jae Hee

AU - Kim, Tae Il

AU - Min, Byung So

AU - Kim, Nam Kyu

AU - Kim, Won Ho

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Background: Self-expandable metal stents (SEMSs) provide a promising alternative for initial palliation of malignant bowel obstruction. However, data on the long-term outcomes of SEMSs are limited. Objective: The aim of this study was to compare the long-term outcomes of endoscopic stenting with those of surgery for palliation in patients with incurable obstructive colorectal cancer. Designs and Setting: A retrospective study. Patients: From January 2000 to December 2008, patients with incurable obstructive colorectal cancer who were treated with SEMSs (n = 71) or palliative surgery (n = 73) were reviewed. Interventions: SEMS placement by using through-the-endoscope methods or surgery. Main Outcome Measurements: Success rates and complication rates. Results: Early success rates in the SEMS group and those in the surgery group were not different (95.8% vs 100%, P = .12), and the SEMS group had fewer early complications than the surgery group (15.5% vs 32.9%, P = .015). Although the patency duration of the first stent in the SEMS group was shorter than that in the surgery group (P < .001), the median patency duration after a second stenting was comparable to that of the surgery group (P = .239). There were more late complications in the SEMS group than in the surgery group (P = .028), but the rates of major complications did not differ between the 2 groups (P = .074). Limitations: Retrospective and single-center study. Conclusions: SEMSs were not only an effective and acceptable therapy for initial palliation of malignant colorectal obstruction, but they also showed long-term efficacy comparable to that with surgery.

AB - Background: Self-expandable metal stents (SEMSs) provide a promising alternative for initial palliation of malignant bowel obstruction. However, data on the long-term outcomes of SEMSs are limited. Objective: The aim of this study was to compare the long-term outcomes of endoscopic stenting with those of surgery for palliation in patients with incurable obstructive colorectal cancer. Designs and Setting: A retrospective study. Patients: From January 2000 to December 2008, patients with incurable obstructive colorectal cancer who were treated with SEMSs (n = 71) or palliative surgery (n = 73) were reviewed. Interventions: SEMS placement by using through-the-endoscope methods or surgery. Main Outcome Measurements: Success rates and complication rates. Results: Early success rates in the SEMS group and those in the surgery group were not different (95.8% vs 100%, P = .12), and the SEMS group had fewer early complications than the surgery group (15.5% vs 32.9%, P = .015). Although the patency duration of the first stent in the SEMS group was shorter than that in the surgery group (P < .001), the median patency duration after a second stenting was comparable to that of the surgery group (P = .239). There were more late complications in the SEMS group than in the surgery group (P = .028), but the rates of major complications did not differ between the 2 groups (P = .074). Limitations: Retrospective and single-center study. Conclusions: SEMSs were not only an effective and acceptable therapy for initial palliation of malignant colorectal obstruction, but they also showed long-term efficacy comparable to that with surgery.

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