PWE-314 Efficacy and complications in the use of self-expanding colonic stents for large bowel obstruction at a single centre: an analysis of 13 years experience
| العنوان: | PWE-314 Efficacy and complications in the use of self-expanding colonic stents for large bowel obstruction at a single centre: an analysis of 13 years experience |
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| المؤلفون: | T Bryant, TC Dudding, OE Orr, EL Kershaw, JS Knight |
| المصدر: | Gut. 64:A348.3-A349 |
| بيانات النشر: | BMJ, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | medicine.medical_specialty, Palliative treatment, business.industry, Colorectal cancer, Gastroenterology, medicine.disease, Extrinsic compression, Surgery, Stoma, Large bowel obstruction, Single centre, Medicine, Complication, business, Colonic stent |
| الوصف: | Introduction Self-expandable metal stents (SEMS) may be used in patients presenting with large bowel obstruction (LBO) and offer a less invasive alternative to surgery and thus avoid the potential need for a stoma. Method A retrospective analysis of all patients who underwent attempted SEMS placement for LBO between 2001 and 2014 at a university teaching hospital. Patients were identified from the radiology database and hospital coding via the hospital’s informatics system. Results Over the 13-year review period, a primary SEMS was attempted in 143 patients, median age 72 (range 25–108) years, sex ratio 83 males: 60 females. Indications for SEMS were palliative treatment of colorectal cancer (CRC) 101; as bridging prior to resectional surgery for CRC 14; extrinsic compression in 19 and for benign disease in 8 patients. SEMS placement was successful in 110 (77%) patients: in 83 (82%) palliative; 13 (93%) bridging; 12 (63%) compression and 2 (25%) benign groups. 85% of SEMS were placed in the distal colon. In the bridged patients 54% did not require a stoma at subsequent surgery. 91(83%) patients successfully stented had no complication. Of the complications that occurred, 13(15.7%) occurred in palliative, 3(23.1%) bridging, and 3(25%) compression groups. Early complications ( 1 month) occurred in 4 patients, 3 required surgery. Overall median survival post SEMS was 212 days. According to indication for SEMS, 30- and 90-day survival was respectively: palliative 81.2% and 68.2%; bridging 92.3%; compressive 50% and 33.3% and benign 100%. Median (IQR) survival was: palliative 205 (49–425); bridging 766 (408–960) and compression 27 (12–158) days. Conclusion The commonest indication for SEMS placement was malignant LBO from CRC. In palliative patients it has a good success rate and avoids the need for surgery in patients with a limited median survival. As a bridge to surgery in patients undergoing subsequent surgery it has a high success rate but does not always avoid the need for a stoma. Disclosure of interest None Declared. |
| تدمد: | 1468-3288 0017-5749 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_________::cf73fc86a43d07134038398f0f19328bTest https://doi.org/10.1136/gutjnl-2015-309861.760Test |
| رقم الانضمام: | edsair.doi...........cf73fc86a43d07134038398f0f19328b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14683288 00175749 |
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