Complications of Distal Intestinal Occlusion Treatment With Endoluminal Implants

Abstract

IntroductionThe high morbidity and mortality of emergency surgery have led to the use of endoluminal self-expanding metal implants (stents) in the management of intestinal occlusion.The purpose of this study was to review the results of the management of intestinal occlusion treatment in a Colorectal Surgery Unit in those patients who had a stent implant, and the relationship between chemotherapy and complications. Materials and methodsA retrospective study was carried out on patients treated with a stent in a university hospital between 2004 and 2010. ResultsA total of 93 patients were treated, of whom 77 were considered palliative for a stage IV neoplasm of the colon with non-resectable metastases or due to a performance status >2. Other indications were 7 ASA IV patients with acute renal failure, 6 with benign disease, and 3 due to other causes.The technical success and clinical success of the procedure were 93.5% and 78.5%, respectively. Delayed occlusion was 19.3% and perforation 6.4%. There were migration (2.1%) and intestinal bleeding (2.1%) and 1.1% with tenesmus. No significant differences were seen between complications and chemotherapy.The overall mortality was 17.2%. ConclusionsStents, as a definitive treatment option in palliative patients with and without chemotherapy, is an alternative treatment that is not exempt from complications. We believe that in patients with mortality risk factors and patients with tumours with non-resectable metastases it could be the initial treatment of choice.