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Long-term outcome of palliative therapy for malignant colorectal obstruction in patients with unresectable metastatic colorectal cancers: endoscopic stenting versus surgery.

Authors
 Hyun Jung Lee  ;  Sung Pil Hong  ;  Jae Hee Cheon  ;  Tae Il Kim  ;  Byung So Min  ;  Nam Kyu Kim  ;  Won Ho Kim 
Citation
 Gastrointestinal Endoscopy, Vol.73(3) : 535-542, 2011 
Journal Title
 Gastrointestinal Endoscopy 
ISSN
 0016-5107 
Issue Date
2011
Abstract
BACKGROUND: Self-expandable metal stents (SEMSs) provide a promising alternative for initial palliation of malignant bowel obstruction. However, data on the long-term outcomes of SEMSs are limited. OBJECTIVE: The aim of this study was to compare the long-term outcomes of endoscopic stenting with those of surgery for palliation in patients with incurable obstructive colorectal cancer. DESIGNS AND SETTING: A retrospective study. PATIENTS: From January 2000 to December 2008, patients with incurable obstructive colorectal cancer who were treated with SEMSs (n = 71) or palliative surgery (n = 73) were reviewed. INTERVENTIONS: SEMS placement by using through-the-endoscope methods or surgery. MAIN OUTCOME MEASUREMENTS: Success rates and complication rates. RESULTS: Early success rates in the SEMS group and those in the surgery group were not different (95.8% vs 100%, P = .12), and the SEMS group had fewer early complications than the surgery group (15.5% vs 32.9%, P = .015). Although the patency duration of the first stent in the SEMS group was shorter than that in the surgery group (P < .001), the median patency duration after a second stenting was comparable to that of the surgery group (P = .239). There were more late complications in the SEMS group than in the surgery group (P = .028), but the rates of major complications did not differ between the 2 groups (P = .074). LIMITATIONS: Retrospective and single-center study. CONCLUSIONS: SEMSs were not only an effective and acceptable therapy for initial palliation of malignant colorectal obstruction, but they also showed long-term efficacy comparable to that with surgery.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92729
DOI
10.1016/j.gie.2010.10.052
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김남규(Kim, Nam Kyu) ; 김원호(Kim, Won Ho) ; 김태일(Kim, Tae Il) ; 민병소(Min, Byung Soh) ; 이현정(Lee, Hyun Jung) ; 천재희(Cheon, Jae Hee) ; 홍성필(Hong, Sung Pil)
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Full Text
http://www.sciencedirect.com/science/article/pii/S0016510710023023
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