Juakiem Wassem Y, Singh Kelita, Ofosu Andrew, Ramai Daryl, Persaud Alana, Tabibian James H, Rodrigues-Pinto Eduardo, Girotra Mohit, Barakat Monique T
Division of Gastroenterology, Stanford University, Stanford, CA 94305, USA.
Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA 02115, USA.
Cancers (Basel). 2024 Sep 27;16(19):3309. doi: 10.3390/cancers16193309.
Colonic endoluminal stent placement is a commonly utilized and effective endoscopic approach for the management of malignant large bowel obstruction and is an emerging approach for the management of some benign etiologies of large bowel obstruction. However, recent studies evaluating the evolution of clinical scenarios and patient populations for which stenting is performed in real-world practice are lacking.
We assessed colonic stent utilization patterns in a tertiary care academic medical center over the past 10 years. We analyzed the demographics and patient and procedure characteristics of the initial (first half of study period) and latter (second half of the study period) procedures to assess trends over time using standard descriptive statistics.
Our analysis was notable due to its provision of some novel insights. The frequency of colonic stent placement procedures increased significantly over time by comparison of the procedure volume for the initial 5-year interval (22 colonic stent procedures) relative to the latter 5-year interval (49 colonic stent procedures) ( = 0.03). The median age of patients who underwent colonic stent placement was significantly lower in the latter 5 years, compared with the initial 5 years of the study period (mean of 81.41 vs. 58.73 years, respectively, < 0.001). The increased diversity of indications for colonic stent placement was also noted over time.
Our data highlight the evolution of colonic stent placement in tertiary care practice over time and are notable for some interesting trends, including the increased utilization of colonic stent placement over time, the broadening of indications for colonic stent placement to include benign indications, and lower patient age at the time of colonic stent placement over time. These findings will help inform the clinical practice of colonic stent placement and provide a foundation to guide future research on the topic.
结肠腔内支架置入术是治疗恶性大肠梗阻常用且有效的内镜治疗方法,也是治疗某些大肠梗阻良性病因的新兴方法。然而,目前缺乏对现实世界中进行支架置入术的临床情况和患者群体演变的评估研究。
我们评估了一家三级医疗学术中心过去10年的结肠支架使用模式。我们分析了初始阶段(研究期前半段)和后期阶段(研究期后半段)手术的人口统计学、患者及手术特征,使用标准描述性统计方法评估随时间的趋势。
我们的分析提供了一些新颖的见解,值得关注。通过比较最初5年期间(22例结肠支架手术)和后5年期间(49例结肠支架手术)的手术量,发现结肠支架置入术的频率随时间显著增加(P = 0.03)。与研究期的前5年相比,后5年接受结肠支架置入术的患者中位年龄显著更低(分别为81.41岁和58.73岁,P < 0.001)。随着时间推移,结肠支架置入术的适应证多样性也有所增加。
我们的数据突出了三级医疗实践中结肠支架置入术随时间的演变,一些有趣的趋势值得关注,包括结肠支架置入术的使用随时间增加、适应证扩大至包括良性适应证以及结肠支架置入时患者年龄随时间降低。这些发现将有助于指导结肠支架置入术的临床实践,并为该主题的未来研究提供基础。