Examination of Physicians’ Perception of the Indications of Colorectal Stents in the Management of Malignant Large Bowel Obstruction: A Provincial Survey

Figure 2

This figure shows the adherence of respondents to recently published guidelines (European and American Societies of Gastrointestinal Endoscopy, 2014), assessing the indications of colorectal stents in the management of acute malignant large bowel obstruction. Eight clinical scenarios were formulated as shown in Box 1. Participants could choose from four therapeutic options (as described below), one of which was deemed to be in keeping with guidelines. A pooled analysis was performed taking into account all case scenarios, yielding an overall rate of adherence of 50.4% (95% CI 40.7–59.3%) of participants opting for a therapeutic strategy recommended by guidelines. The therapeutic options are clarified: “Option A: Insert a colorectal stent, with view to decompressive surgery in 5–10 days; Option B: Insert a colorectal stent regardless of whether the patient may have subsequent surgery or not; Option C: Send patient to the operating room for urgent decompressive surgery; Option D: Observe patient’s symptoms for 24–48 hours with nasogastric suction."