engleski

SELF-EXPANDABLE METAL STENTS IN PATIENTS WITH MALIGNANT BOWEL OBSTRUCTION: A SINGLE TERTIARY CENTER EXPERIENCE

Background: Colorectal cancer is one of the most common malignancies worldwide. Bowel obstruction is possible, but not a frequent tumor complication. Self-expandable metal stent (SEMS) placing is of high importance for solving this condition. It could be used as a bridge to surgery (BTS) or for palliative approach when surgery is not an option. Aim: To present the experience of a single tertiary center in SEMS usage from 2010 to 2016. An important step forward was made when SEMS replaced the previously used conventional surgical management of bowel obstruction. Materials and methods: This is a retrospective study of self-expandable metal stents inserted by a single endoscopist in our center. Searching our clinical database 46 patients with SEMS were identified. We performed analysis of patients' demographic characteristics, as well as, analysis of the type of stents used, placement success rate, and number and type of complications. Results: SEMS was placed in 46 patients. 30 patients were male (65.2%). The median age was 74 years, range from 43 to 88 years. We divided our patients into two categories: BTS and palliative purpose. The most common stent positioning was rectum in 37% of patients (n=17). Other localizations were: right-sided colon 4.3% (n=2), ascendens 17.4% (n=8), transverse colon 4.3% (n=2), left colon 4.3% (n=2), sigmoid 21.7% (n=10) and rectosigmoid 10.9% (n=5). Most of SEMS used (56.4%) were 10 cm in length. Other stent dimensions were 5, 8 and 12 cm. To deduce, stent placing solved obstruction problems in all 46 patients (100%), while simultaneously the complication incidence was low. The most frequent early complication was perforation (n=4), while the most common late complication was restenosis (n=2). Conclusion: Our experience gained during a six year period confirmed that use of SEMS has provided an important improvement in malignant bowel obstruction management with its less invasive and simpler to use technique followed by a rather low complication rate.

self-expandable metal stent; colorectal cancer; malignant bowel obstruction; bridge to surgery; palliative approach

nije evidentirano