Outcomes of Palliative Colonic Stent Placement in Malignant Colonic Obstruction: Experience from a Tertiary Care Oncology Center in India
Introduction Colonic self-expanding metal stent (SEMS) placement is the preferred method for palliation of malignant colonic obstruction. We analyzed outcomes of patients who underwent colonic SEMS placement for palliation at a tertiary care oncology center in Western India. Methods Retro...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2023-03-01
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| Series: | Journal of Digestive Endoscopy |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1749073 |
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| author | Sridhar Sundaram Raosaheb Rathod Prachi Patil Kiran Mane Vishal Seth Avanish Saklani Ashwin Desouza Shaesta Mehta |
| author_facet | Sridhar Sundaram Raosaheb Rathod Prachi Patil Kiran Mane Vishal Seth Avanish Saklani Ashwin Desouza Shaesta Mehta |
| author_sort | Sridhar Sundaram |
| collection | DOAJ |
| description | Introduction Colonic self-expanding metal stent (SEMS) placement is the preferred method for palliation of malignant colonic obstruction. We analyzed outcomes of patients who underwent colonic SEMS placement for palliation at a tertiary care oncology center in Western India.
Methods Retrospective review of the endoscopy database was done for patients who underwent colonic SEMS placement at our center between January 2013 and September 2021. Demographic details, intent of stent placement, site of obstruction, length of stricture, technical success of stenting, clinical success, and complications (both immediate and long term) were noted.
Results Sixty-one patients underwent colonic SEMS placement during the study period (mean age 53.6 years, 50.7% men). Obstruction was due to primary colonic malignancy in 43 (70.5%) patients and extracolonic malignancies in 18 (29.5%) patients. Most common extracolonic malignancy was gallbladder cancer in 8 (44.4%) patients. Most common site of obstruction was sigmoid colon in 18 (29.5%) patients. Proximal colonic obstruction was seen in 17 (27.9%) patients. Peritoneal metastases were seen in 26 (42.6%) patients. Colonoscopy revealed an impassable stenosis in 58 (95.1%) patients. Median length of stricture was 5 cm (range 2–9 cm). Technical success was achieved in 98.3% (60/61). Clinical success was achieved in 51 (86.4%) patients. Perforation during colonic SEMS placement was seen in 2 (3.4%) patients. Stent migration was seen in 3 (5.9%) patients, needing surgery for retrieval in all 3 patients. Over a median follow-up of 9 months (0–21 months), stent block was seen in 7 (13.7%) patients. Stent block developed after a median period of 6 months. Of these patients, three patients underwent SEMS placement within the SEMS and the other four patients underwent surgery.
Conclusion Colonic SEMS placement achieves good palliation of malignant colonic obstruction in approximately 87% patients. Long-term complications like obstruction occur in a few patients after a median duration of 6 months. |
| first_indexed | 2024-04-09T20:41:37Z |
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| id | doaj.art-e53db875e1e64f24bc46b86f54723d7b |
| institution | Directory Open Access Journal |
| issn | 0976-5042 0976-5050 |
| language | English |
| last_indexed | 2024-04-09T20:41:37Z |
| publishDate | 2023-03-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
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| series | Journal of Digestive Endoscopy |
| spelling | doaj.art-e53db875e1e64f24bc46b86f54723d7b2023-03-30T00:12:48ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Digestive Endoscopy0976-50420976-50502023-03-01140100801310.1055/s-0042-1749073Outcomes of Palliative Colonic Stent Placement in Malignant Colonic Obstruction: Experience from a Tertiary Care Oncology Center in IndiaSridhar Sundaram0Raosaheb Rathod1Prachi Patil2Kiran Mane3Vishal Seth4Avanish Saklani5Ashwin Desouza6Shaesta Mehta7Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaDepartment of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaDepartment of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaDepartment of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaDepartment of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaDepartment of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaDepartment of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaDepartment of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaIntroduction Colonic self-expanding metal stent (SEMS) placement is the preferred method for palliation of malignant colonic obstruction. We analyzed outcomes of patients who underwent colonic SEMS placement for palliation at a tertiary care oncology center in Western India. Methods Retrospective review of the endoscopy database was done for patients who underwent colonic SEMS placement at our center between January 2013 and September 2021. Demographic details, intent of stent placement, site of obstruction, length of stricture, technical success of stenting, clinical success, and complications (both immediate and long term) were noted. Results Sixty-one patients underwent colonic SEMS placement during the study period (mean age 53.6 years, 50.7% men). Obstruction was due to primary colonic malignancy in 43 (70.5%) patients and extracolonic malignancies in 18 (29.5%) patients. Most common extracolonic malignancy was gallbladder cancer in 8 (44.4%) patients. Most common site of obstruction was sigmoid colon in 18 (29.5%) patients. Proximal colonic obstruction was seen in 17 (27.9%) patients. Peritoneal metastases were seen in 26 (42.6%) patients. Colonoscopy revealed an impassable stenosis in 58 (95.1%) patients. Median length of stricture was 5 cm (range 2–9 cm). Technical success was achieved in 98.3% (60/61). Clinical success was achieved in 51 (86.4%) patients. Perforation during colonic SEMS placement was seen in 2 (3.4%) patients. Stent migration was seen in 3 (5.9%) patients, needing surgery for retrieval in all 3 patients. Over a median follow-up of 9 months (0–21 months), stent block was seen in 7 (13.7%) patients. Stent block developed after a median period of 6 months. Of these patients, three patients underwent SEMS placement within the SEMS and the other four patients underwent surgery. Conclusion Colonic SEMS placement achieves good palliation of malignant colonic obstruction in approximately 87% patients. Long-term complications like obstruction occur in a few patients after a median duration of 6 months.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1749073obstructioncolorectal neoplasiastentstreatment outcome |
| spellingShingle | Sridhar Sundaram Raosaheb Rathod Prachi Patil Kiran Mane Vishal Seth Avanish Saklani Ashwin Desouza Shaesta Mehta Outcomes of Palliative Colonic Stent Placement in Malignant Colonic Obstruction: Experience from a Tertiary Care Oncology Center in India Journal of Digestive Endoscopy obstruction colorectal neoplasia stents treatment outcome |
| title | Outcomes of Palliative Colonic Stent Placement in Malignant Colonic Obstruction: Experience from a Tertiary Care Oncology Center in India |
| title_full | Outcomes of Palliative Colonic Stent Placement in Malignant Colonic Obstruction: Experience from a Tertiary Care Oncology Center in India |
| title_fullStr | Outcomes of Palliative Colonic Stent Placement in Malignant Colonic Obstruction: Experience from a Tertiary Care Oncology Center in India |
| title_full_unstemmed | Outcomes of Palliative Colonic Stent Placement in Malignant Colonic Obstruction: Experience from a Tertiary Care Oncology Center in India |
| title_short | Outcomes of Palliative Colonic Stent Placement in Malignant Colonic Obstruction: Experience from a Tertiary Care Oncology Center in India |
| title_sort | outcomes of palliative colonic stent placement in malignant colonic obstruction experience from a tertiary care oncology center in india |
| topic | obstruction colorectal neoplasia stents treatment outcome |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1749073 |
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