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Colorectal stenting in malignant large bowel obstruction: the learning curve
D Williams1, R Law, A M Pullyblank
1Department of Surgery, North Bristol NHS Trust, Frenchay Hospital, Frenchay Park Road, Bristol, BS16 1LE, UK.
Colorectal stenting with self-expanding metal stents (SEMSs) shows a steep learning curve. Improved technical success and a shift toward emergency preoperative stenting were observed over time.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Self-expanding metal stents (SEMSs) are vital for managing metastatic colorectal cancer and obstructing tumors.
- Their use as a bridge to surgery is increasing.
Purpose of the Study:
- To analyze the learning curve for colorectal stenting.
- To identify changes in practice over a three-year period.
Main Methods:
- A case series of 40 patients undergoing colorectal stenting.
- Data collected over a single surgeon's learning curve.
Main Results:
- Technical success rates improved from 82% to 94%.
- Average stents per procedure decreased from 1.7 to 1.
- Practice shifted from elective palliative to emergency preoperative stenting.
Conclusions:
- A significant learning curve exists for SEMS placement in malignant colorectal obstruction.
- Approximately 20 cases are recommended for operator proficiency.
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