Self-Expanding Metallic Stents (SEMS) in Left-Sided Colonic Cancer--a Cancer Center Experience.
BACKGROUND AND STUDY AIMS
Self-Expanding Metallic Stents (SEMS) are a surgery-sparing option for malignant colonic obstruction. They can be inserted as a "bridge to surgery" (BTS) for potentially curable disease, or as a palliative measure, thereby avoiding the higher morbidity and mortality associated with surgery. The objective of this study was to report our local experience of left-sided colonic stents.


METHODS
Data on 49 patients was collected retrospectively from Oct 2008 to Nov 2014 at our cancer centre. This included demographics, baseline clinical characteristics, indications for SEMS placement (bridge to surgery/palliative), technical and clinical success, complications, and the mean patency of duration. Survival in both groups was also plotted on a Kaplan-Meier chart.


RESULTS
A total of 49 patients with colorectal carcinoma (CRC) of the left side were enrolled. The mean age was 50 years (range 18-86). Ninety percent of patients had disease involving the rectum, sigmoid colon, or both. Forty-seven percent (n = 23) of patients had stent insertion as a BTS, whereas 53% (n = 26) had the procedure with palliative intent. Technical and clinical success rates were 96 and 88%, respectively. The clinical success rate of the palliative arm was lower than that of the BTS arm (p = 0.024). 87.5% (n = 42) had no procedure-related complications. Technical failure, perforation, and stent migration/expulsion, were each observed in 4% of cases. Mean stent patency duration was 83.9 days.


CONCLUSION
SEMS insertion for left-sided malignant colonic obstruction is a safe and effective procedure when used either as a bridge to surgery or with palliative intent.
['Saeed|Kamran Muddasar|KM|', 'Zafar|Waleed|W|', 'Masood|Muhammad Adnan|MA|', 'Khattak|Shahid|S|', 'Syed|Aamir Ali|AA|', 'Yusuf|Muhammed Aasim|MA|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D003110:Colonic Neoplasms D005260:Female D005500:Follow-Up Studies D006801:Humans D007415:Intestinal Obstruction D008297:Male D008875:Middle Aged D009367:Neoplasm Staging D016522:Oncology Service, Hospital D010166:Palliative Care D012189:Retrospective Studies D000069322:Self Expandable Metallic Stents D015996:Survival Rate D016896:Treatment Outcome D055815:Young Adult
Colonic obstruction Bridge to surgery Colorectal carcinoma Self expanding metallic stents