Outcomes of Self-Expandable Metallic Stent Insertion on Acute Colorectal Obstruction: A Single Endoscopist Experience

Vitoon Chinswangwatanakul, Chotirot Angkurawaranon, Chainarong Phalanusitthepha, Asada Methasate, Atthaphorn Trakarnsanga, Jirawat Swangsri, Thawatchai Akaraviputh

Abstract


AIM: Self-expandable metallic stents (SEMS) have been widely used to relieve acute malignant colorectal obstruction. Many studies came from multiple centers or multiple endoscopists. The primary objective of this study is to evaluate oncologic outcomes of SEMS done by a single endoscopist. Method: From January 2003 to December 2013, retrospective medical records reviewed a total of 123 patients who underwent colonoscopy with SEMS by a single surgeon’s experience. Patients’ clinicopathological data were analyzed. Results: The intent of the SEMS placement was for palliation 28.5% and for bridge-to-surgery 71.5%. The technical success was found in 120 patients (97.6%) and the clinical success was 118 patients (98.3%). Early and late complications occurred in 8 patients (6.5%) and 13 patients (10.5%) subsequently. Overall SEMS complications were 17%. Most common overall SEMS complications were stent migration (4.8%) and obstruction (4.1%). Conclusion: SEMS is feasible and safe in the management of acute malignant colorectal obstruction with the advantage of relieving obstruction, bridge to surgery, and acceptable complication rates. The good outcomes of SEMS can be dependable on the volume center.

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