A Japanese Prospective, Multicenter Study of Colonic Stenting for Palliation Using a High Axial Force Self-Expandable Metal Stent for Malignant Large Bowel Obstruction in 200 Patients.
Rei IshibashiTakashi SasakiHiroyuki IsayamaTakeaki MatsuzawaToshio KuwaiTomonori YamadaShuji SaitoMasafumi TomitaToshiyasu ShiratoriSatoshi IkedaHideki KanazawaMitsuhiro FujishiroIruru MaetaniYoshihisa SaidaPublished in: Journal of clinical medicine (2023)
Evidence of the efficacy and safety of colorectal stent placement for palliation remains insufficient. This single-arm, prospective, multicenter study with a WallFlex enteral colonic stent included 200 consecutive patients with malignant large bowl obstruction in the palliation cohort. The technical and clinical success, as well as stent patency and complications as short-term (≤7 days) and long-term (>7 days) outcomes, of high axial force self-expandable metal stent (SEMS) placement was evaluated. The technical and clinical success rates were 98.5% and 94.5%, respectively. Non-recurrent colorectal obstruction at 1 year was 63.9%, and 71.2% of the patients remained free of recurrent colorectal obstruction until death or the last follow-up. Fifty-six patients (28.0%) received chemotherapy, and five patients were administered bevacizumab after stent placement. The overall complication rate was 47%, including four (2.0%) early-onset and ten (5.0%) late-onset perforations, mostly due to stent-edge injury. Only the use of a long SEMS was a risk factor for perforation. In conclusion, endoscopic colorectal stenting using high axial force SEMS is an effective and safe procedure for palliation in patients with malignant colorectal obstruction. However, care should be taken to avoid perforation at the stent edge when using a long SEMS.
Keyphrases
- end stage renal disease
- early onset
- late onset
- ejection fraction
- chronic kidney disease
- peritoneal dialysis
- healthcare
- prognostic factors
- single molecule
- coronary artery disease
- ultrasound guided
- radiation therapy
- risk factors
- acute coronary syndrome
- chronic pain
- quality improvement
- pain management
- ulcerative colitis
- locally advanced