Assessment of Endoscopic Colonic Stenting outcomes in Patients with Acute Malignant Colonic Obstruction

Abstract

Background: The traditional method of treating patients with acute malignant colonic obstruction (AMCO) is emergency surgery, which is often accompanied by the development of severe complications and high mortality. Endoscopic colonic stenting with self-expandable metal stents (SEMS) is considered to be a promising way to treat such patients. However, its capabilities are not yet fully explored. This paper presents a cross-sectional study of the results of endoscopic colonic stenting using SEMS in AMCO patients, performed in 2016 - 2020.Objective: to clarify the outcomes of endoscopic stenting with SEMS in AMCO patients and identify the factors that influence its result.Materials and Methods. The study included 218 patients with AMCO in whom surgeons made an attempt to eliminate the acute colonic obstruction using the method of endoscopic stenting. The capabilities of endoscopic stenting were assessed on the basis of calculated technical and clinical efficacy, the incidence of complications and mortality. To identify the factors that can predict the outcome of a stenting attempt, all patients were divided into two groups: a group of clinical success (182 patients) and a group of clinical failure (36 patients). The groups were subjected to comparative analysis.Results. The analysis of the obtained results registered that the technical efficiency of endoscopic stenting of the colon is 91.7% and its clinical efficiency is 83.5%, the incidence of intra-abdominal complications is 8.3%, the incidence of somatic complications is 11.9%, the mortality is 5%. Comparative analysis of the groups revealed differences (with p <0.05) for the oncological process stage, the duration and the severity of intestinal obstruction. Conclusion. Endoscopic stenting of the colon with SEMS is an effective way to treat patients with AMCO. Its success can vary depending on the severity of trophic disorders in the intestinal wall.