Korean J Gastrointest Endosc.  2008 May;36(5):274-281.

The Effect of Self-Expanding Metallic Stent Insertion for the Treatment ofMalignant Colorectal Obstruction

Affiliations
  • 1Department of Internal Medicine, Ajou University College of Medicine, Suwon, Korea. jinhkim@ajou.ac.kr
  • 2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Soonchunhyang University College of Medicine Bucheon Hospital, Bucheon, Korea.
  • 4Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 5Department of Internal Medicine, Seoul National University College of Medicine Bundang Hospital, Seongnam, Korea.
  • 6Department of Internal Medicine, The Catholic University of Korea College of Medicine, St. Vincent Hospital, Suwon, Korea.
  • 7Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS: The aim of this study was to evaluate the clinical and cost effectiveness of the use of stent insertion for malignant colorectal obstruction as compared with performing emergency surgery.
METHODS
We retrospectively reviewed the medical records of 201 patients. Malignant colorectal obstructions caused by a resectable tumor were treated with preoperative stenting followed by surgery (group A, n=55) or emergency surgery (group B, n=59). Malignant obstructions caused by an unresectable cancer were treated with palliative stenting (group C, n=58) or palliative emergency surgery (group D, n=29).
RESULTS
The one-staged radical resection rate was significantly higher in group A patients than in group B patients (87.3% vs. 52.5%, p<0.05). Post-operative complications were more frequent in group A patients than in group B patients (9.1% vs. 32.2%, p<0.05). The admission period was significantly shorter for group A patients than for group B patients (25.0 days vs. 33.7 days, p<0.05). The medical cost was not different for group A and group B patients. Life-long stoma formation was necessary for 15.5% of group C patients and 69% of group D patients, respectively. The admission period was significantly shorter for group C patients than group D patients (10.5 days vs. 22.7 days, p<0.05). The medical cost was not different for group C and D patients.
CONCLUSIONS
Stent insertion was an effective treatment modality for malignant colorectal obstruction.

Keyword

Stent insertion; Malignant obstruction; Colon cancer
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