J Korean Soc Radiol.  2012 Dec;67(6):433-440. 10.3348/jksr.2012.67.6.433.

A Dual Expandable Stent for Treatment of Malignant Colorectal Obstruction: Long-Term Follow-Up Results

Affiliations
  • 1Department of Radiology, Kosin University College of Medicine, Gospel Hospital, Busan, Korea. gsjung@medimail.co.kr

Abstract

PURPOSE
To analyze the long-term results and to evaluate the efficacy of a dual expandable stent for the treatment of malignant colorectal strictures.
MATERIALS AND METHODS
Under the fluoroscopic guidance, stents were placed in 60 patients with malignant colorectal strictures. A dual stent consists of two stents, the outer stent was placed into the stricture which was followed by coaxial placement of the inner bare stent. Technical and clinical success rates, complications, patient survival and stent patency during the follow-up period were evaluated in this study.
RESULTS
Stent placement was technically successful in 57 of 60 patients (95%). Of them, obstructive symptoms resolved within two days in 12/12 (100%) patients in the preoperative group and in 36/45 (80%) patients in the palliative group. Complications associated with this procedure were perforation (n = 5), migration (n = 3), and tumor overgrowth (n = 2). Each of the six patients in the preoperative group underwent conventional laparotomy and laparoscopic surgery, respectively. The mean interval between stent insertion and surgery was nine days. In the palliative group, the median survival was 159 days (mean; 235) and the median patency of stent was 116 days (mean; 185). 1-month, 3-month, 6-month, 12-month and 24-month stent patency were 75%, 60%, 27%, 13% and 7%, respectively.
CONCLUSION
Insertion of a dual expandable nitinol stent into malignant colorectal obstruction is a safe and effective procedure for the palliative treatment of malignant colorectal obstruction. This procedure is also effective for preoperative decompression.

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