Radiologic Placement of Uncovered Stents for the Treatment of Malignant Colonic Obstruction Proximal to the Descending Colon.

Abstract

To evaluate the safety, feasibility, and patency rates of radiologic placement of uncovered stents for the treatment of malignant colonic obstruction proximal to the descending colon. This was a retrospective, single-center study. From May 2003 to March 2015, 53 image-guided placements of uncovered stents (44 initial placements, 9 secondary placements) were attempted in 44patients (male:female=23:21; mean age, 71.8years). The technical and clinical success, complication rates, and patency rates of the stents were also evaluated. Technical success was defined as the successful deployment of the stent under fluoroscopic guidance alone and clinical success was defined as the relief of obstructive symptoms or signs within 48h of stent deployment. In total, 12 (27.3%) patients underwent preoperative decompression, while 32 (72.7%) underwent decompression with palliative intent. The technical success rate was 93.2% (41/44) for initial placement and 88.9% (8/9) for secondary placement. Secondary stent placement in the palliative group was required in nine patients after successful initial stent placement due to stent obstruction from tumor ingrowth (n=7) and stent migration (n=2). The symptoms of obstruction were relieved in all successful cases (100%). In the palliative group, the patency rates were 94.4% at 1month, 84.0% at 3months, 64.8% at 6months, and 48.6% at 12months. The radiologic placement of uncovered stents for the treatment of malignant obstruction proximal to the descending colon is feasible and safe, and provides acceptable clinical results.