Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Scand J Gastroenterol. 2024 Jan-Jun;59(1):108-111. doi: 10.1080/00365521.2023.2254877. Epub 2023 Sep 11.
Stenting of malignant colon obstruction is used as a bridge to surgery or as an alternative to surgical colostomy in a palliative setting. Current guidelines recommend stent placement as the first line of treatment in colonic obstruction in both curative and palliative settings. However, it is unclear whether the location of the malignant obstruction influences the outcome of the stenting procedure. The goal of this study was to compare the outcomes of colonic stents between proximal and distal colonic strictures with regard to technical and clinical success and the risk of adverse events.
A multi-center retrospective cohort was composed of patients who underwent a colonic stent placement at two tertiary hospitals between 2013 and 2021. The technical and clinical outcome, stent type used, duration of post-procedural hospital stay and complications were noted.
A total of 148 patients who underwent colonic stenting were identified. 41 patients underwent stent placement in the proximal colon and 107 patients underwent a distal stent placement. There was no difference in technical success (100% vs 96.3%, = 0.209), clinical success (97.0% vs 89.6%, = 0.199) or complications (24.4% vs 37.4%, = 0,135).
Technical success and clinical success rates are high and do not differ between stent locations. There is no significant difference in complication rates between proximal and distal colonic stents.
在姑息治疗中,恶性结肠梗阻的支架置入术可作为手术的桥梁,或替代结肠造口术。目前的指南建议在根治性和姑息性治疗中,支架置入术均应作为结肠梗阻的一线治疗方法。然而,恶性梗阻的位置是否会影响支架置入术的结果尚不清楚。本研究旨在比较近端和远端结肠狭窄的结肠支架置入术在技术和临床成功率以及不良事件风险方面的结果。
一项多中心回顾性队列研究纳入了 2013 年至 2021 年期间在两家三级医院接受结肠支架置入术的患者。记录技术和临床结果、使用的支架类型、术后住院时间和并发症。
共纳入 148 例接受结肠支架置入术的患者。41 例患者在近端结肠进行支架置入,107 例患者在远端结肠进行支架置入。技术成功率(100%比 96.3%, = 0.209)、临床成功率(97.0%比 89.6%, = 0.199)或并发症发生率(24.4%比 37.4%, = 0.135)均无差异。
技术成功率和临床成功率均较高,且支架位置之间无差异。近端和远端结肠支架的并发症发生率无显著差异。