Long-term success of colonic stent insertion is influenced by indication but not by length of stent or site of obstruction

Abstract

Stent insertion plays an important part in the management of acute colonic obstruction. There are limited data on factors influencing short- and long-term success. We investigated indications, technical and clinical success rates, complication rates and the factors influencing them. Patients were identified from our prospective colonic stent database (2000-2008). One hundred and four stents were attempted in 96 patients (technical success rate, 83.3%). Clinical short-term success was observed in 74 (77.1%) patients. Follow-up data available for 57 patients showed clinical long-term success in 77% (44/57). Multiple logistic regression analysis showed a significant decline in technical success over the study period (p = 0.041). Patients with colonic malignancy had significantly higher long-term success rates (81%), compared to those with extra-colonic malignancies (43%) (p = 0.049). Length of stent and site of obstruction were not significant factors. Early complications occurred in 10%, and late complications, in 26.3% of cases. Colonic stent insertion provides symptom relief in over 70% when used as a long-term solution. Complication rates are high, and a significant minority of patients requires re-intervention. Obstruction caused by extra-colonic malignancy is far less likely to be permanently palliated by a stent, in comparison to colonic malignancy.