Late complications related to palliative stenting in patients with obstructing colorectal cancer

• Published in: Minimally invasive therapy and allied technologies 2013-12, Vol.22 (6), p.352-358
• Main Authors: Huhtinen, Heikki, Varpe, Pirita, Karvonen, Jukka, Rantala, Arto, Grönroos, Juha M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; colonoscopy; Colorectal cancer; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Databases, Factual; Feasibility Studies; Female; Foreign-Body Migration; Hospitals, University; Humans; Intestinal Obstruction - etiology; Intestinal Obstruction - pathology; Intestinal Obstruction - surgery; Life Expectancy; Male; Middle Aged; Palliative Care - methods; Postoperative Complications - epidemiology; Retrospective Studies; self-expanding stent; Stents; Treatment Outcome
• ISSN: 1364-5706; 1365-2931
• DOI: 10.3109/13645706.2013.797911

Abstract Introduction: Self-expanding metal stents (SEMSs) are increasingly used for the palliative treatment of incurable obstructing colorectal cancer. The aim of the current study was to evaluate clinical outcome, including technical and clinical success of stenting, and to identify factors associated with late complications of SEMS in palliation of incurable obstructing colorectal cancer. Material and methods: Between 2003 and 2010 details of 56 patients who underwent an attempt of SEMS insertion for obstructive incurable colorectal cancer at Turku University Hospital were recorded to our database prospectively and analyzed retrospectively. Results: Technical success was achieved in 42 patients (75%) and clinical success in 39 patients (70%). Late complications related to SEMS occurred in 13 patients (31%). Ten patients (24%) needed re-intervention because of a complication: Eight ostomies, one Hartmann´s procedure due to late perforation and one re-stenting because of stent migration. Three patients with stent-related complications were treated conservatively. Chemotherapy and prolonged survival were risk factors for SEMS-related late complications and re-intervention. Conclusion: SEMS insertion is a feasible procedure for the palliative treatment of obstructing colorectal cancer in patients with severe comorbidities and short life expectancy. However, for patients who are candidates for chemotherapy and have a longer life expectancy, other treatment options such as palliative tumor resection should also be considered.