Document Detail

Favorable Long-term Clinical Outcome of Uncovered D-Weave Stent Placement as Definitive Palliative Treatment for Malignant Colorectal Obstruction.
MedLine Citation:
PMID:  22874606     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: : Most self-expandable metallic stents for colorectal placement are uncovered because of the high migration rate of covered stents. However, the optimal stent design for colorectal use remains unclear.
OBJECTIVE: : The purpose of this study was to evaluate the efficacy and safety of a double-wire woven uncovered stent for definitive palliative treatment of malignant colorectal obstruction.
DESIGN: : This study was a prospective, single-arm, observational clinical study of patients enrolled between December 2005 and September 2010.
SETTINGS: : This study was conducted at a referral hospital in Japan.
PATIENTS: : Twenty-four consecutive patients with malignant colorectal obstruction were included in the study.
INTERVENTIONS: : A double-wire woven uncovered stent was placed by use of a standard through-the-scope endoscopic placement technique.
MAIN OUTCOME MEASURES: : Technical, initial clinical, and long-term clinical success were measured. Long-term clinical success was defined as sustained relief of obstructive symptoms without reintervention until the patient's death.
RESULTS: : The Karnofsky performance status score before stent placement was 60 (median, interquartile range, 42.5-67.5). Twenty of 24 patients had primary colorectal cancer, and 4 had extracolorectal malignancies. The site of obstruction was the ascending colon in 10 patients, descending colon in 4 patients, sigmoid colon in 7 patients, and rectum in 3 patients. Technical, initial, and long-term clinical success rates were 100%, 100%, and 83%. Median stent patency time was 149 days (interquartile range, 45-198 days). Median survival time after stent placement was 155 days (interquartile range, 68-231 days). Four patients (17%) had negative outcomes including stent occlusion by tumor ingrowth (8%) and stent migration (8%). The highest Karnofsky performance status score after stent placement was 70 (median; interquartile range, 50-70). The Karnofsky performance status score improved after stent placement (p = 0.002).
LIMITATIONS: : This study was limited because it was a single-arm, single-center study, and it had a small sample size.
CONCLUSIONS: : Endoscopic placement of double-wire woven uncovered stents is effective and safe as definitive palliative treatment for patients with malignant colorectal obstruction.
Kenji Tominaga; Iruru Maetani; Koichiro Sato; Hiroaki Shigoka; Shigefumi Omuta; Sayo Ito; Yoshinori Saigusa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  55     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  983-9     Citation Subset:  IM    
Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
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