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Clinical outcomes following secondary self-expandable metal stent (SEMS) insertion due to previous stent migration in malignant colorectal obstruction

Title
 Clinical outcomes following secondary self-expandable metal stent (SEMS) insertion due to previous stent migration in malignant colorectal obstruction 
Authors
 A. Ra Choi ; Jin Young Yoon ; Jae Hee Cheon ; Won Ho Kim ; Tae Il Kim ; Sung Pil Hong ; Soo Jung Park ; Hui Won Jang ; Hyun Jung Lee 
Issue Date
2013
Journal Title
 Surgical Endoscopy and Other Interventional Techniques 
ISSN
 0930-2794 
Citation
 Surgical Endoscopy and Other Interventional Techniques, Vol.27(9) : 3288~3296, 2013 
Abstract
BACKGROUND: There has been no research on the clinical outcomes of secondary self-expandable metal stent (SEMS) placement after initial stent migration. Therefore, this study aimed to assess the clinical outcomes of secondary SEMS placement after initial stent migration compared to the outcomes of secondary SEMS placement done for reasons other than migration and identify factors predictive of long-term outcomes. METHODS: Between January 2005 and February 2011, a total of 422 patients underwent SEMS insertion for malignant colorectal obstruction at Severance Hospital. Of these, there were 98 cases of secondary SEMS placement, 38 of which were due to previous stent migration. We compared the clinical outcomes of secondary SEMS between stent migration and nonmigration groups. We also sought to identify risk factors for long-term outcomes of secondary SEMS after initial stent migration. RESULTS: The baseline clinical characteristics were similar between the two groups. The technical and clinical success rates of secondary SEMS insertion in the migration and nonmigration groups were 94.7% and 83.3% (p = 0.09) and 73.7% and 53.3% (p = 0.122), respectively. In the migration group, sustained clinical success after secondary SEMS was associated with the absence of complications after insertion of the first stent (p < 0.001) and a longer time interval (more than 100 days) between the first and second stent insertion (p = 0.011). CONCLUSIONS: Our data showed that secondary colorectal SEMS after stent migration is safe and effective. Moreover, the sustained clinical success of the secondary stent following migration was dependent on the outcomes of the first stent.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87548
DOI
10.1007/s00464-013-2907-6
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
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Link
 http://link.springer.com/article/10.1007%2Fs00464-013-2907-6
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