Self-expanding metallic stents for large bowel obstruction
| Autor: | W. L. Craig, Malcolm A. Loudon, J K Hussey, C. Mackay |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Palliative care Large bowel obstruction Colonic Diseases Postoperative Complications Interquartile range medicine Humans Elective surgery Adverse effect Emergency Treatment Aged Retrospective Studies Aged 80 and over business.industry Palliative Care Cancer Retrospective cohort study Middle Aged medicine.disease Surgery Treatment Outcome Relative risk Colonic Neoplasms Female Stents business Intestinal Obstruction |
| Zdroj: | British Journal of Surgery. 98:1625-1629 |
| ISSN: | 1365-2168 0007-1323 |
| DOI: | 10.1002/bjs.7644 |
| Popis: | Background Self-expanding metallic stents (SEMS) may relieve colonic obstruction as definitive therapy or as a bridge to elective surgery. Methods This was a retrospective longitudinal cohort study of patients undergoing insertion of SEMS for large bowel obstruction at one institution. Scrutiny of the radiology department's coding system allowed identification of all patients undergoing colonic stent insertion between 2002 and 2008. Data were extracted from patient case notes and investigation reports. Results Eighty-two patients with a median age of 75 (interquartile range (i.q.r.) 43–94) years underwent stent insertion, 71 for palliation and 11 as a bridge to surgery. Obstruction was due to malignant disease in 67 patients and had a benign cause in 15. Median survival in the palliative setting was 103 (i.q.r. 44–317) days. Complications occurred in 43 patients, of whom 22 underwent unplanned surgery. High-grade obstruction (relative risk (RR) 2·05; P = 0·055) and benign disease (RR 3·45; P < 0·001) were associated with risk of adverse events. Conclusion SEMS should not be used for large bowel obstruction with benign pathology. |
| Databáze: | OpenAIRE |
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