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 language | English |
|---|---|
| Pages (from-to) | 694-699 |
| Number of pages | 6 |
| Journal | Diseases of the Colon and Rectum |
| Volume | 57 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2014 Jan 1 |
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All Science Journal Classification (ASJC) codes
- Gastroenterology
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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 journal › Article
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
Y1 - 2014/1/1
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.
UR - http://www.scopus.com/inward/record.url?scp=84901807817&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84901807817&partnerID=8YFLogxK
U2 - 10.1097/DCR.0000000000000061
DO - 10.1097/DCR.0000000000000061
M3 - Article
C2 - 24807593
AN - SCOPUS:84901807817
VL - 57
SP - 694
EP - 699
JO - Diseases of the Colon and Rectum
JF - Diseases of the Colon and Rectum
SN - 0012-3706
IS - 6
ER -