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首页> 外文期刊>Surgical Endoscopy >Stenting for malignant colorectal obstruction: A single-center experience with 101 patients
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Stenting for malignant colorectal obstruction: A single-center experience with 101 patients

机译：支架置入治疗结肠直肠恶性梗阻：单中心经验101例

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Background: Self-expanding metal stents (SEMS) are used for colorectal obstruction preoperatively and palliatively. Limited data on the use of stents for obstruction caused by extracolonic malignancies exist, and the results are unclear. Our goal was to evaluate the efficacy and safety of SEMS for patients stented as a bridge to surgery and as palliation for colorectal cancer or extracolonic malignancies. Methods: Between 1998 and 2009, a total of 101 patients underwent 108 stenting procedures for malignant colorectal obstruction. The results were studied retrospectively. Results: Of the study cohort, 11 patients were stented as a bridge to surgery. For palliatively stented patients, the etiology of obstruction was colorectal cancer in 66 patients and extracolonic malignancy in 24. Overall technical success was 99% and clinical success 88%. Complications occurred for 20 (20%) patients in 22 of 108 procedures. Complications included perforation (n = 6), recurrent obstruction (n = 8), and stent migration (n = 4). A median time to complication was 81.5 days. The overall stent placement-related mortality was 2/101 (2%). For patients stented as a bridge to surgery, a primary anastomosis in elective operations was achieved for 90% (9/10). In the palliation groups, patients with colorectal cancer had significantly higher clinical success rates than patients with extracolonic malignancies (94% vs. 65%, P = 0.0005). There was no difference in complications, operation, and stoma rates between the palliation groups. Conclusions: SEMS is a safe and effective treatment for patients stented as a bridge to surgery or as palliation due to colorectal cancer. Stents are also useful in relieving obstruction due to extracolonic malignancies, but the clinical failure rate is higher than for colorectal cancer.
机译：背景：自扩张金属支架（SEMS）用于术前和姑息治疗结直肠癌。关于使用支架治疗结肠外恶性肿瘤引起的阻塞的数据有限，结果尚不清楚。我们的目标是评估SEMS对置入支架的患者的有效性和安全性，这些支架可作为手术的桥梁以及对结直肠癌或结肠外恶性肿瘤的缓解。方法：1998年至2009年，共有101例患者接受了108例因结肠直肠恶性梗阻而置入支架的手术。回顾性研究结果。结果：在该研究队列中，有11例患者被置入支架以通向手术。对于姑息性支架置入术患者，阻塞的病因是结直肠癌66例，结肠外恶性肿瘤24例。总体技术成功率为99％，临床成功率为88％。 108例手术中有22例发生了并发症（20％）。并发症包括穿孔（n = 6），复发性阻塞（n = 8）和支架迁移（n = 4）。并发症的中位时间为81.5天。支架置入相关的总死亡率为2/101（2％）。对于支架置入作为手术桥梁的患者，择期手术实现了原发性吻合术，占90％（9/10）。在缓解组中，结直肠癌患者的临床成功率显着高于结肠外恶性肿瘤患者（94％vs. 65％，P = 0.0005）。缓解组之间的并发症，手术和造口率没有差异。结论：SEMS是治疗因结肠直肠癌而成为手术或缓解疾病的患者的安全有效的治疗方法。支架在缓解结肠外恶性肿瘤引起的阻塞方面也很有用，但其临床失败率高于结直肠癌。

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