World journal of gastroenterology · 2014
Outcomes after stenting for malignant large bowel obstruction without radiologist support.
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Mehmood Rao Khalid, Parker Jody, Kirkbride Patricia, Ahmed Shakil, Akbar Fayyaz, Qasem Eays, Zeeshan Muhammad, Jehangir Ernest
Аннотация
AIM: To assess outcomes after colonic stent insertion for obstructing colorectal malignancies performed by an endoscopist without radiologist support.
METHODS: This is a retrospective study of all stents inserted by a single surgeon in a District General Hospital over an eight year period. All stents were inserted for patients with acute large bowel obstruction secondary to a malignant colorectal pathology either for palliation or as a bridge to surgery. Procedures were performed by a single surgeon endoscopically with fluoroscopic control in the X-ray department but without the support of an interventional radiologist. Data was collected prospectively on a pre-designed database.
RESULTS: The indication for all stent procedures was an obstructing colorectal malignancy. Out of 53 patients, the overall success rate was 90.6%. Eight patients had a stent intended as a bridge to surgery and 45 as a palliative procedure. Technical success was achieved in 50 out of 53 procedures (94.3%) and clinical success in 48 of those remaining 50 (96.0%). Those with unsuccessful technical or clinical procedures went on to have defunctioning stomas to treat their obstruction. There were six complications from the technically successful stents (12.0%). These included one migration, one persisting obstructive symptoms and four cases of tumour overgrowth of the stents at a later date. Haemorrhagic complications, perforation or mortality were not observed in our series. Our results are comparable to several other studies assessing stent outcomes for obstructing bowel cancer.
CONCLUSION: Our data suggests that colorectal stents can be inserted without radiologist support by an adequately trained individual with good outcomes.
METHODS: This is a retrospective study of all stents inserted by a single surgeon in a District General Hospital over an eight year period. All stents were inserted for patients with acute large bowel obstruction secondary to a malignant colorectal pathology either for palliation or as a bridge to surgery. Procedures were performed by a single surgeon endoscopically with fluoroscopic control in the X-ray department but without the support of an interventional radiologist. Data was collected prospectively on a pre-designed database.
RESULTS: The indication for all stent procedures was an obstructing colorectal malignancy. Out of 53 patients, the overall success rate was 90.6%. Eight patients had a stent intended as a bridge to surgery and 45 as a palliative procedure. Technical success was achieved in 50 out of 53 procedures (94.3%) and clinical success in 48 of those remaining 50 (96.0%). Those with unsuccessful technical or clinical procedures went on to have defunctioning stomas to treat their obstruction. There were six complications from the technically successful stents (12.0%). These included one migration, one persisting obstructive symptoms and four cases of tumour overgrowth of the stents at a later date. Haemorrhagic complications, perforation or mortality were not observed in our series. Our results are comparable to several other studies assessing stent outcomes for obstructing bowel cancer.
CONCLUSION: Our data suggests that colorectal stents can be inserted without radiologist support by an adequately trained individual with good outcomes.