Treatment of left colon malignant obstruction by placement of self-expandable metal stents / 中华消化杂志

ABSTRACT

Objective To evaluate the clinical efficacy and safety of endoscopic metal stenting in lef t colon malignant obstruction as decompression bridging therapy and palliative t herapy. Methods Twelve pathologically confirmed and surgically indicated patients with left colo n malignant obstruction underwent metal stent placement as decompression treatme nt. Permanent metal stent placement was performed in 5 left colon cancer obstru ction patients without surgical indication. The successful rate of stent deploym ent, procedure-related complication, stent patency and long-term complication were observed in treated patients. Results ①Stent placement was successful on the first occasion in 15 of 17 (88%) cases, and total successful rate was 100%. No severe procedure-related complication wa s found. ②The mean duration of placed stent in bridging cases was 6.1 days(4-9 days), and all patients were transferred to one-stage tumor resection after d ecompression by bridging stent and bowel preparation without complications of fi stula development and intraperitoneal infection. One case developed colon perfor ation 4 days after stent insertion and received immediate operation. ③ The mean effective patency duration of placed stent in palliative cases was 81.7 days(61 -119 days). Tumor ingrowth and reobstruction were noticed in 2 cases, within 62 and 119 days respectively. Stent migration within 61 days in 1 patient was deve loped. Conclusions As an effective and safe bridging palliative therapy, decompression metal stent p lacement may be applied to unresectable and metastatic left colon malignant canc er patients without surgical indication.