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Self-expanding metallic stents for large bowel obstruction
C D Mackay1, W Craig, J K Hussey
1Department of General Surgery, Aberdeen Royal Infirmary, Aberdeen, UK. cmackay@doctors.org.uk
The British Journal of Surgery
|August 23, 2011
Summary
Self-expanding metallic stents (SEMS) can relieve colonic obstruction. However, SEMS are not recommended for large bowel obstruction caused by benign conditions due to increased risk of adverse events.
Area of Science:
- Gastroenterology
- Interventional Radiology
- Surgical Oncology
Background:
- Self-expanding metallic stents (SEMS) offer a treatment option for colonic obstruction, serving as definitive therapy or a bridge to surgery.
- Colonic obstruction presents a significant clinical challenge requiring effective management strategies.
Purpose of the Study:
- To evaluate the safety and efficacy of SEMS in managing large bowel obstruction.
- To determine the outcomes of SEMS insertion in palliative and bridge-to-surgery settings.
- To identify risk factors associated with adverse events following SEMS placement.
Main Methods:
- Retrospective longitudinal cohort study.
- Inclusion of 82 patients who underwent colonic stent insertion between 2002 and 2008.
- Data extraction from patient records and radiology reports.
Main Results:
- 71 patients received SEMS for palliation, 11 as a bridge to surgery.
- Malignant disease (67 patients) was the primary cause of obstruction.
- Complications occurred in 43 patients, with 22 requiring unplanned surgery. Benign pathology was associated with a higher risk of adverse events (RR 3.45, P < 0.001).
Conclusions:
- Self-expanding metallic stents (SEMS) are not advised for large bowel obstruction due to benign pathology.
- Careful patient selection is crucial for optimizing SEMS outcomes in malignant colonic obstruction.
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