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Gastroenterology Research and Practice
Volume 2012 (2012), Article ID 296347, 6 pages
http://dx.doi.org/10.1155/2012/296347
Clinical Study

Self-Expanding Metal Stenting for Palliation of Patients with Malignant Colonic Obstruction: Effectiveness and Efficacy on 255 Patients with 12-Month's Follow-up

1Endoscopy Unit, Bispebjerg Hospital, Bispebjerg Bakke 23, Entrance 7B, 2400 Copenhagen NV, Denmark
2Unidad de Endoscopia, Servicio de Aparato Digestivo, Hospital Doctor Josep Trueta, Carretera Franca s/n, Catalunya, 17007 Girona, Spain
3Gastro-enterologie, Onze Lieve Vrouw Ziekenhuis, Moorselbaan 164, 9300 Aalst, Belgium
4Department of Digestive Endoscopy, Istituto Clinico Humanitas, Via Manzoni 56, 20089 Rozzano, Italy
5Gastroenterology Unit, Saint Savas Hospital, 171 Alexadras Avenue, 11522 Athens, Greece
6Department of Surgical Endoscopy, University Hospital Tuebingen, Geissweg 3, 72076 Tuebingen, Germany
7Department-Colorectal Surgery, Groote Schuur Hospital, Private Bag, Observatory, Cape Town 7937, South Africa
8WallFlex Enteral Colonic Stent for Relieving Malignant Colorectal Obstruction, Boston Scientific, Natick, MA 01760, USA

Received 7 March 2012; Accepted 8 April 2012

Academic Editor: Mohammad Ahmad Al-Shatouri

Copyright © 2012 Søren Meisner et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Self-expanding metal stents can alleviate malignant colonic obstruction in incurable patients and avoid palliative stoma surgery. Objective. Evaluate stent effectiveness and safety on palliation of patients with malignant colorectal strictures. Design. Two prospective, one Spanish and one global, multicenter studies. Settings. 39 centers (22 academic, 17 community hospitals) from 13 countries. Patients. A total of 257 patients were enrolled, and 255 patients were treated with a WallFlex uncovered enteral colonic stent. Follow-up was up to 12 months or until death or retreatment. Interventions(s). Self-expanding metal stent placement. Main Outcome Measures. Procedural success, clinical success, and safety. Results. Procedural success was 98.4% (251). Clinical success rates were 87.8% at 30 days, 89.7% at 3 months, 92.8% at 6 months, and 96% at 12 months. Overall perforation rate was 5.1%. Overall migration rate was 5.5%. Overall death rate during follow-up was 48.6% (124), with 67.7% of deaths related to the patient’s colorectal cancer, unrelated in 32.3%. Only 2 deaths were related to the stent or procedure. Limitations. No control group. Conclusions. The primary palliative option for patients with malignant colonic obstruction should be self-expanding metal stent placement due to high rates of technical success and efficacy in symptom palliation and few complications.