IDDF2021-ABS-0128 Self-expanding metallic stent for palliation of malignant colorectal cancer: a single tertiary referral center experience

Abstract

<h3>Background</h3> 13% of CRC in the late stage present with intestinal obstruction and there is no clear consensus on how best to manage this clinical emergency. The purpose of this study was to evaluate the effectiveness of Self-expanding metallic stents (SEMS) placement in CRC stenoses in the western region of KSA. <h3>Methods</h3> A retrospective review of SEMS placed in King Abdullah Medical City, Makkah, for histological proven inoperable CRC stenosis was done including, demographics data, the success of stent placement, complication, re-intervention and mortality. <h3>Results</h3> 26 SEMS were placed in 25 patients. Median age was 51 years (range 37-84) with 64% (16) males, all CRC had distant metastasis and involved the left side of the colon, except for one located in the hepatic flexure. All SEMS were uncovered with mean length 9 cm. SEMS was placed successfully in all the cases, except one (96%). Two SEMS placements in sigmoid resulted in perforation requiring emergency surgery, both survived till date. One of the SEMS failed to expand despite appropriate placement ending in colostomy. Tumor in-growth in one case resulted in further obstruction 6 months following SEMS placement. This was successfully treated by restenting with SEMS. There was no SEMS migration or bleeding. Mortality was 52% (13). Chemotherapy was given to 56% (14) with one having a perforation. Clinical success of relieving obstruction without complication was achieved in 88%. <h3>Conclusions</h3> Placement of SEMS for palliation of obstruction due to CRC in our center was effective in relieving colonic obstruction with complication rates comparable to other studies.