The role of primary colectomy after successful endoscopic stenting in patients with obstructive metastatic colorectal cancer

Hyun Jung Lee, Soo Jung Park, Byung So Min, JaeHee Cheon, Tae Il Kim, Namkyu Kim, Won Ho Kim, Sung Pil Hong

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: Although the initial clinical efficacy of self-expandable metal stents is acceptable, doubt still remains about long-term clinical outcomes and complications. OBJECTIVE: The aim of this study was to evaluate the stoma formation rate and risk factors for complications after successful stenting in patients with obstructive metastatic colorectal cancer. DESIGN: This was a tertiary-care center retrospective study. PATIENTS: From January 2000 to December 2010, 130 patients with unresectable obstructive colorectal cancer received successful self-expandable metal stent placement. Among them, 14 patients received primary colectomy after successful stenting. INTERVENTIONS: Self-expandable metal stent placement and primary colectomy were performed. MAIN OUTCOME MEASURES: The stoma formation rate and complications were measured. RESULTS: In patients with successful stenting, stoma formation rates at 1 and 2 years were 15.6% (95% CI, 8.74-22.4) and 24.4% (95% CI, 13.8-35.0), and the median patency duration was 157 days (range, 2-1590 days). However, long-term complications occurred in 58 patients (44.6%), including reobstruction (32.6%), stent migration (10.3%), and perforation (7.8%), and a large number of reinterventions (45.7%) and hospitalizations (37/9%) were needed to manage complications. In multivariate analysis, primary colectomy after successful endoscopic stenting was a negative predictive factor for reobstruction (OR, 0.12; 95% CI, 0.02-0.99; p = 0.04). LIMITATIONS: This was a retrospective, single-center study. CONCLUSIONS: To reduce stent-related late complications, primary colectomy after successful endoscopic stenting could be a therapeutic option in patients who have unresectable colorectal cancer with obstruction, especially in those who expect long-term survival.

Original languageEnglish
Pages (from-to)694-699
Number of pages6
JournalDiseases of the Colon and Rectum
Volume57
Issue number6
DOIs
Publication statusPublished - 2014 Jan 1

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Colectomy
Colorectal Neoplasms
Stents
Tertiary Care Centers
Hospitalization
Multivariate Analysis
Retrospective Studies
Survival
Self Expandable Metallic Stents

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Lee, Hyun Jung ; Park, Soo Jung ; Min, Byung So ; Cheon, JaeHee ; Kim, Tae Il ; Kim, Namkyu ; Kim, Won Ho ; Hong, Sung Pil. / The role of primary colectomy after successful endoscopic stenting in patients with obstructive metastatic colorectal cancer. In: Diseases of the Colon and Rectum. 2014 ; Vol. 57, No. 6. pp. 694-699.
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abstract = "BACKGROUND: Although the initial clinical efficacy of self-expandable metal stents is acceptable, doubt still remains about long-term clinical outcomes and complications. OBJECTIVE: The aim of this study was to evaluate the stoma formation rate and risk factors for complications after successful stenting in patients with obstructive metastatic colorectal cancer. DESIGN: This was a tertiary-care center retrospective study. PATIENTS: From January 2000 to December 2010, 130 patients with unresectable obstructive colorectal cancer received successful self-expandable metal stent placement. Among them, 14 patients received primary colectomy after successful stenting. INTERVENTIONS: Self-expandable metal stent placement and primary colectomy were performed. MAIN OUTCOME MEASURES: The stoma formation rate and complications were measured. RESULTS: In patients with successful stenting, stoma formation rates at 1 and 2 years were 15.6{\%} (95{\%} CI, 8.74-22.4) and 24.4{\%} (95{\%} CI, 13.8-35.0), and the median patency duration was 157 days (range, 2-1590 days). However, long-term complications occurred in 58 patients (44.6{\%}), including reobstruction (32.6{\%}), stent migration (10.3{\%}), and perforation (7.8{\%}), and a large number of reinterventions (45.7{\%}) and hospitalizations (37/9{\%}) were needed to manage complications. In multivariate analysis, primary colectomy after successful endoscopic stenting was a negative predictive factor for reobstruction (OR, 0.12; 95{\%} CI, 0.02-0.99; p = 0.04). LIMITATIONS: This was a retrospective, single-center study. CONCLUSIONS: To reduce stent-related late complications, primary colectomy after successful endoscopic stenting could be a therapeutic option in patients who have unresectable colorectal cancer with obstruction, especially in those who expect long-term survival.",
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The role of primary colectomy after successful endoscopic stenting in patients with obstructive metastatic colorectal cancer. / Lee, Hyun Jung; Park, Soo Jung; Min, Byung So; Cheon, JaeHee; Kim, Tae Il; Kim, Namkyu; Kim, Won Ho; Hong, Sung Pil.

In: Diseases of the Colon and Rectum, Vol. 57, No. 6, 01.01.2014, p. 694-699.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The role of primary colectomy after successful endoscopic stenting in patients with obstructive metastatic colorectal cancer

AU - Lee, Hyun Jung

AU - Park, Soo Jung

AU - Min, Byung So

AU - Cheon, JaeHee

AU - Kim, Tae Il

AU - Kim, Namkyu

AU - Kim, Won Ho

AU - Hong, Sung Pil

PY - 2014/1/1

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N2 - BACKGROUND: Although the initial clinical efficacy of self-expandable metal stents is acceptable, doubt still remains about long-term clinical outcomes and complications. OBJECTIVE: The aim of this study was to evaluate the stoma formation rate and risk factors for complications after successful stenting in patients with obstructive metastatic colorectal cancer. DESIGN: This was a tertiary-care center retrospective study. PATIENTS: From January 2000 to December 2010, 130 patients with unresectable obstructive colorectal cancer received successful self-expandable metal stent placement. Among them, 14 patients received primary colectomy after successful stenting. INTERVENTIONS: Self-expandable metal stent placement and primary colectomy were performed. MAIN OUTCOME MEASURES: The stoma formation rate and complications were measured. RESULTS: In patients with successful stenting, stoma formation rates at 1 and 2 years were 15.6% (95% CI, 8.74-22.4) and 24.4% (95% CI, 13.8-35.0), and the median patency duration was 157 days (range, 2-1590 days). However, long-term complications occurred in 58 patients (44.6%), including reobstruction (32.6%), stent migration (10.3%), and perforation (7.8%), and a large number of reinterventions (45.7%) and hospitalizations (37/9%) were needed to manage complications. In multivariate analysis, primary colectomy after successful endoscopic stenting was a negative predictive factor for reobstruction (OR, 0.12; 95% CI, 0.02-0.99; p = 0.04). LIMITATIONS: This was a retrospective, single-center study. CONCLUSIONS: To reduce stent-related late complications, primary colectomy after successful endoscopic stenting could be a therapeutic option in patients who have unresectable colorectal cancer with obstruction, especially in those who expect long-term survival.

AB - BACKGROUND: Although the initial clinical efficacy of self-expandable metal stents is acceptable, doubt still remains about long-term clinical outcomes and complications. OBJECTIVE: The aim of this study was to evaluate the stoma formation rate and risk factors for complications after successful stenting in patients with obstructive metastatic colorectal cancer. DESIGN: This was a tertiary-care center retrospective study. PATIENTS: From January 2000 to December 2010, 130 patients with unresectable obstructive colorectal cancer received successful self-expandable metal stent placement. Among them, 14 patients received primary colectomy after successful stenting. INTERVENTIONS: Self-expandable metal stent placement and primary colectomy were performed. MAIN OUTCOME MEASURES: The stoma formation rate and complications were measured. RESULTS: In patients with successful stenting, stoma formation rates at 1 and 2 years were 15.6% (95% CI, 8.74-22.4) and 24.4% (95% CI, 13.8-35.0), and the median patency duration was 157 days (range, 2-1590 days). However, long-term complications occurred in 58 patients (44.6%), including reobstruction (32.6%), stent migration (10.3%), and perforation (7.8%), and a large number of reinterventions (45.7%) and hospitalizations (37/9%) were needed to manage complications. In multivariate analysis, primary colectomy after successful endoscopic stenting was a negative predictive factor for reobstruction (OR, 0.12; 95% CI, 0.02-0.99; p = 0.04). LIMITATIONS: This was a retrospective, single-center study. CONCLUSIONS: To reduce stent-related late complications, primary colectomy after successful endoscopic stenting could be a therapeutic option in patients who have unresectable colorectal cancer with obstruction, especially in those who expect long-term survival.

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