Bowel function following insertion of self-expanding metallic stents for palliation of colorectal cancer
| Autor: | I. Barros D'Sa, A. Tottle, R J Davies, AL Fowler, P. Birch, T. A. Cook, ME Lucarotti |
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| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Colorectal cancer Colon medicine.medical_treatment Perforation (oil well) Prosthesis Design Lesion Prosthesis Implantation Colon surgery medicine Humans Survival rate Aged Retrospective Studies Aged 80 and over business.industry Palliative Care Gastroenterology Stent Retrospective cohort study Middle Aged medicine.disease Comorbidity Surgery Survival Rate Treatment Outcome Female Stents medicine.symptom business Colorectal Neoplasms Gastrointestinal Motility Intestinal Obstruction Follow-Up Studies |
| Zdroj: | Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. 7(3) |
| ISSN: | 1462-8910 |
| Popis: | Objective Self-expanding metallic stents (SEMS) are animportant addition to the treatment of large bowelobstruction. The aim of this study was firstly to assessbowel function following SEMS placement and secondlyto identify any potential factors which might aid in theprediction of technical failure of stent insertion.Methods A review of all patients undergoing attemptedSEMS placement for palliation of malignant left-sidedcolorectal obstruction over a four-year period (1st May2000–30th April 2004) was performed.Results Twenty-one patients (12 male) with a medianage of 76 years (range 48–92 years) were included, 11with metastatic disease and 10 severe comorbidity. SEMSinsertion was technically successful in 16 (76%) of 21cases. Contrast successfully passed through the obstruct-ing lesion in all 16 cases where SEMS placement wastechnically successful. It only passed through 1 of 5 caseswhere stenting was not possible (P ¼ 0.0008, Fisher’sExact test). Complications included colonic perforation(1 case), stent migration (1 case) and tumour ingrowthrequiring a second stent (1 case). Median survival afterSEMS was 12 months (range 1–30 months), and 9patients died during follow-up. Median bowel frequencyfollowing SEMS was 3.5 times per day (range 1–7). Eightpatients always passed a liquid stool, 3 others regularlyrequired laxatives and one further patient with poorfunction after stenting requested a defunctioning stoma.Conclusion Failure of contrast to pass through theobstructing lesion may predict those cases where stentingwill not be technically possible. Median survival followingSEMS insertion is encouraging in this series, but bowelfunction is often poor. Expected bowel function shouldbe discussed fully when consenting patients for a SEMS,particularly those with metastatic disease who are other-wise fit for resectional surgery.Keywords Colorectal cancer, palliation, self-expandingmetallic stents, bowel function |
| Databáze: | OpenAIRE |
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