Outcomes of secondary stent-in-stent self-expandable metal stent insertion for malignant colorectal obstruction

Jin Young Yoon, Yoon Suk Jung, Sung Pil Hong, Tae Il Kim, Won Ho Kim, JaeHee Cheon

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Although self-expandable metal stents (SEMSs) are widely used for the treatment of malignant colorectal obstruction, they often become occluded by tumor ingrowth. Objectives: To determine the therapeutic effectiveness of secondary stent-in-stent SEMS insertion for the management of occluded SEMS in patients with malignant colorectal obstruction and to identify predictive factors associated with clinical outcomes in terms of immediate clinical success, stent patency, and complications. Design: Retrospective case series. Setting: A tertiary-care academic medical center in South Korea. Patients: Between November 2005 and July 2010, among a total of 309 patients who underwent SEMS insertion for unresectable malignant colorectal obstruction at Severance Hospital, 87 underwent secondary SEMS insertion. Of these, 36 patients underwent secondary SEMS placement as stent-in-stent. Interventions: Placement of secondary colorectal stent-in-stent SEMSs. Main Outcome Measurements: Immediate and long-term clinical success and complications. Results: Immediate clinical success was achieved in 27 of 36 patients (75%), and the median duration of stent patency was 170 days. Factors associated with immediate clinical success included a long duration between the previous stent and stent-in-stent insertion. Moreover, the absence of carcinomatosis was associated with long-term clinical success. Limitations: This was a retrospective, nonrandomized, single-center study. Conclusions: Secondary stent-in-stent SEMS placement led to good outcomes in patients with malignant colorectal obstruction, despite a slightly lower success rate compared with primary SEMS placement. Patency duration of the primary SEMS and carcinomatosis were important factors predictive of immediate and long-term clinical success of stent-in-stent insertion, respectively.

Original languageEnglish
Pages (from-to)625-633
Number of pages9
JournalGastrointestinal Endoscopy
Volume74
Issue number3
DOIs
Publication statusPublished - 2011 Sep 1

Fingerprint

Stents
Self Expandable Metallic Stents
Carcinoma
Republic of Korea
Tertiary Healthcare

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Yoon, Jin Young ; Jung, Yoon Suk ; Hong, Sung Pil ; Kim, Tae Il ; Kim, Won Ho ; Cheon, JaeHee. / Outcomes of secondary stent-in-stent self-expandable metal stent insertion for malignant colorectal obstruction. In: Gastrointestinal Endoscopy. 2011 ; Vol. 74, No. 3. pp. 625-633.
@article{3aa94ade5d5e4dd1badd599128c0c7ec,
title = "Outcomes of secondary stent-in-stent self-expandable metal stent insertion for malignant colorectal obstruction",
abstract = "Background: Although self-expandable metal stents (SEMSs) are widely used for the treatment of malignant colorectal obstruction, they often become occluded by tumor ingrowth. Objectives: To determine the therapeutic effectiveness of secondary stent-in-stent SEMS insertion for the management of occluded SEMS in patients with malignant colorectal obstruction and to identify predictive factors associated with clinical outcomes in terms of immediate clinical success, stent patency, and complications. Design: Retrospective case series. Setting: A tertiary-care academic medical center in South Korea. Patients: Between November 2005 and July 2010, among a total of 309 patients who underwent SEMS insertion for unresectable malignant colorectal obstruction at Severance Hospital, 87 underwent secondary SEMS insertion. Of these, 36 patients underwent secondary SEMS placement as stent-in-stent. Interventions: Placement of secondary colorectal stent-in-stent SEMSs. Main Outcome Measurements: Immediate and long-term clinical success and complications. Results: Immediate clinical success was achieved in 27 of 36 patients (75{\%}), and the median duration of stent patency was 170 days. Factors associated with immediate clinical success included a long duration between the previous stent and stent-in-stent insertion. Moreover, the absence of carcinomatosis was associated with long-term clinical success. Limitations: This was a retrospective, nonrandomized, single-center study. Conclusions: Secondary stent-in-stent SEMS placement led to good outcomes in patients with malignant colorectal obstruction, despite a slightly lower success rate compared with primary SEMS placement. Patency duration of the primary SEMS and carcinomatosis were important factors predictive of immediate and long-term clinical success of stent-in-stent insertion, respectively.",
author = "Yoon, {Jin Young} and Jung, {Yoon Suk} and Hong, {Sung Pil} and Kim, {Tae Il} and Kim, {Won Ho} and JaeHee Cheon",
year = "2011",
month = "9",
day = "1",
doi = "10.1016/j.gie.2011.05.025",
language = "English",
volume = "74",
pages = "625--633",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "3",

}

Outcomes of secondary stent-in-stent self-expandable metal stent insertion for malignant colorectal obstruction. / Yoon, Jin Young; Jung, Yoon Suk; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho; Cheon, JaeHee.

In: Gastrointestinal Endoscopy, Vol. 74, No. 3, 01.09.2011, p. 625-633.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Outcomes of secondary stent-in-stent self-expandable metal stent insertion for malignant colorectal obstruction

AU - Yoon, Jin Young

AU - Jung, Yoon Suk

AU - Hong, Sung Pil

AU - Kim, Tae Il

AU - Kim, Won Ho

AU - Cheon, JaeHee

PY - 2011/9/1

Y1 - 2011/9/1

N2 - Background: Although self-expandable metal stents (SEMSs) are widely used for the treatment of malignant colorectal obstruction, they often become occluded by tumor ingrowth. Objectives: To determine the therapeutic effectiveness of secondary stent-in-stent SEMS insertion for the management of occluded SEMS in patients with malignant colorectal obstruction and to identify predictive factors associated with clinical outcomes in terms of immediate clinical success, stent patency, and complications. Design: Retrospective case series. Setting: A tertiary-care academic medical center in South Korea. Patients: Between November 2005 and July 2010, among a total of 309 patients who underwent SEMS insertion for unresectable malignant colorectal obstruction at Severance Hospital, 87 underwent secondary SEMS insertion. Of these, 36 patients underwent secondary SEMS placement as stent-in-stent. Interventions: Placement of secondary colorectal stent-in-stent SEMSs. Main Outcome Measurements: Immediate and long-term clinical success and complications. Results: Immediate clinical success was achieved in 27 of 36 patients (75%), and the median duration of stent patency was 170 days. Factors associated with immediate clinical success included a long duration between the previous stent and stent-in-stent insertion. Moreover, the absence of carcinomatosis was associated with long-term clinical success. Limitations: This was a retrospective, nonrandomized, single-center study. Conclusions: Secondary stent-in-stent SEMS placement led to good outcomes in patients with malignant colorectal obstruction, despite a slightly lower success rate compared with primary SEMS placement. Patency duration of the primary SEMS and carcinomatosis were important factors predictive of immediate and long-term clinical success of stent-in-stent insertion, respectively.

AB - Background: Although self-expandable metal stents (SEMSs) are widely used for the treatment of malignant colorectal obstruction, they often become occluded by tumor ingrowth. Objectives: To determine the therapeutic effectiveness of secondary stent-in-stent SEMS insertion for the management of occluded SEMS in patients with malignant colorectal obstruction and to identify predictive factors associated with clinical outcomes in terms of immediate clinical success, stent patency, and complications. Design: Retrospective case series. Setting: A tertiary-care academic medical center in South Korea. Patients: Between November 2005 and July 2010, among a total of 309 patients who underwent SEMS insertion for unresectable malignant colorectal obstruction at Severance Hospital, 87 underwent secondary SEMS insertion. Of these, 36 patients underwent secondary SEMS placement as stent-in-stent. Interventions: Placement of secondary colorectal stent-in-stent SEMSs. Main Outcome Measurements: Immediate and long-term clinical success and complications. Results: Immediate clinical success was achieved in 27 of 36 patients (75%), and the median duration of stent patency was 170 days. Factors associated with immediate clinical success included a long duration between the previous stent and stent-in-stent insertion. Moreover, the absence of carcinomatosis was associated with long-term clinical success. Limitations: This was a retrospective, nonrandomized, single-center study. Conclusions: Secondary stent-in-stent SEMS placement led to good outcomes in patients with malignant colorectal obstruction, despite a slightly lower success rate compared with primary SEMS placement. Patency duration of the primary SEMS and carcinomatosis were important factors predictive of immediate and long-term clinical success of stent-in-stent insertion, respectively.

UR - http://www.scopus.com/inward/record.url?scp=80052260795&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052260795&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2011.05.025

DO - 10.1016/j.gie.2011.05.025

M3 - Article

VL - 74

SP - 625

EP - 633

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 3

ER -