Efficacy and Safety of Self Expanding Metal Stents (SEMS) in Colonic Malignant Proximal Stenosis

Aims Self-expanding metal stents have been used in the management of colorectal obstruction as an alternative to emergency surgery. Aim of this study is to evaluated efficacy and safety of placement of colonic stent in proximal colon.

Methods A retrospective analysis of all patients referred to our Institute who underwent placement of SEMS for colonic stenosis proximal to the mid transverse due to metastatic and/or extensive locally invasive disease was performed.

Results A total of 31 patients (15 male and 16 female, mean age 62.9) were included. Primitive neoplasia was colon adenocarcinoma in 30 patients, one patient presented colon obstruction secondary to peritoneal carcinosis in gastric adenocarcinoma .Successful insertion with adequate placement of the stent across the stricture was achieved in all patients. 30/31 patients (technical success at 24 hours 96.7 %) had complete deployment of the prosthesis. Clinical success considered at 48-72 hours as absence of bowel distension and return to regular bowel habits occurred in all patients (100 %). Due to prosthesis occlusion one patient underwent stent in stent placement at 10 months from the first procedure.One patient underwent tertiary stent in stent placement, the second and the third stent were positioned at one and three months from the first stenting procedure respectively, with a documented survival of seventeen months after the last procedure.Fifteen patients (48.3 %) performed up of 6 cycle of chemotherapy (> half treatment) and 7 of these (46.6 %) were alive at 12 months from the prosthesis placement and were able to perform the chemotherapy’s established schedule.

Conclusions SEMS placement is a safe and effective procedure for the palliative treatment of colonic obstruction also in the right colon. The proximal localization of the lesion does not influence the high rate of technical and clinical success. Placement of SEMS also permits to begin chemotherapy and/or radiotherapy as soon as possible.

Citation: Orlando D, Assisi D, Venti E Garcés-Duran R, Galdin-Ferreyra M, Delgado-Guillena P et al. eP242 EFFICACY AND SAFETY OF SELF EXPANDING METAL STENTS (SEMS) IN COLONIC MALIGNANT PROXIMAL STENOSIS. Endoscopy 2021; 53: S177.

Publication History

Article published online:
19 March 2021