Large bowel obstruction due to colorectal carcinoma can be safely treated by colonic stent insertion - case series from a UK district general hospital

Colorectal Disease, 04/13/2012

The experience shows that stenting for obstructing colorectal cancer is a safe and effective method of alleviating acute and impending bowel obstruction and can be provided safely and effectively in a district general hospital.

Methods

  • Retrospective audit of all stent insertions in a single district general hospital between August 2003 and December 2009.
  • All patients had presented with acute bowel obstruction caused by malignant colorectal disease and details were collected prospectively and contemporaneously onto a database.
  • Stent insertion was a combined endoscopic and fluoroscopic procedure involving a colorectal surgeon and consultant radiologist.

Results

  • Stenting was attempted on 62 occasions in 54 patients.
  • The technical success rate was 86% and clinical success rate 84%.
  • The indications for stenting were for relief of acute bowel obstruction, palliation and as a bridge to surgery.
  • There were complications in fourteen cases (22.5%) including three perforations and one peri-operative mortality.
  • There were three cases of stent migration, six cases of re-stenosis and two stents became impacted with stool.
  • There were no incidents of acute or delayed haemorrhage in any patients.

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