Bekhor Eliahu Yonathan, Klein Erez, Shmilovich Hila, Marom Gad, Glazer Yair, Bouchard-Fortier Genevieve, Harris Mai, Shlomovitz Eran
Department of Surgery, Rabin Medica Center, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, 38955, Kfar Haroe, Israel.
Surg Endosc. 2025 Feb;39(2):1147-1152. doi: 10.1007/s00464-024-11483-6. Epub 2024 Dec 20.
Malignant bowel obstruction (MBO) is a common complication in advanced and recurrent gynecologic malignancies, with limited treatment options and poor prognosis. Self-expanding metallic stent (SEMS) insertion has emerged as an alternative palliative measure, yet data specific to gynecologic malignancies remains scarce.
A retrospective analysis was conducted on 61 patients with gynecologic malignancies and malignant large bowel obstruction who underwent colorectal stenting between January 2002 and December 2023. Data, including demographics, procedural details, clinical outcomes, and complications, were collected from electronic medical records.
The mean age of patients was 65.7 years, with ovarian cancer being the most common malignancy (77%). "Technical success" of SEMS insertion was achieved in 91.4% of cases, with a "clinical success" rate of 76.7%. Major complications occurred in 2% and 5% of patients at 30- and 90 days post-procedure, respectively. Overall mortality rates were 4% at 30 days and 28% at 90 days.
SEMS for managing MBO is a promising alternative to surgery in patients with advanced or recurrent gynecologic malignancies. It offers high technical and clinical success rates with acceptable complication rates. Further research is needed to delineate optimal patient selection criteria and refine procedural techniques to maximize outcomes in this challenging population.
恶性肠梗阻（MBO）是晚期和复发性妇科恶性肿瘤的常见并发症，治疗选择有限且预后较差。自膨式金属支架（SEMS）置入已成为一种替代性姑息治疗措施，但针对妇科恶性肿瘤的具体数据仍然稀缺。
对2002年1月至2023年12月期间接受结直肠支架置入术的61例患有妇科恶性肿瘤和恶性大肠梗阻的患者进行回顾性分析。从电子病历中收集包括人口统计学、手术细节、临床结果和并发症等数据。
患者的平均年龄为65.7岁，卵巢癌是最常见的恶性肿瘤（77%）。SEMS置入的“技术成功率”在91.4%的病例中实现，“临床成功率”为76.7%。主要并发症分别在术后30天和90天发生在2%和5%的患者中。30天和90天的总死亡率分别为4%和28%。
对于晚期或复发性妇科恶性肿瘤患者，SEMS用于治疗MBO是一种有前景的手术替代方法。它具有较高的技术和临床成功率以及可接受的并发症发生率。需要进一步研究以确定最佳的患者选择标准并完善手术技术，以在这一具有挑战性的人群中使治疗效果最大化。
