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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.

 Hyun Jung Lee  ;  Sung Pil Hong  ;  Jae Hee Cheon  ;  Tae Il Kim  ;  Byung So Min  ;  Nam Kyu Kim  ;  Won Ho Kim 
 GASTROINTESTINAL ENDOSCOPY, Vol.73(3) : 535-542, 2011 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Colon/pathology ; Colon/surgery ; Colorectal Neoplasms/complications ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology* ; Disease-Free Survival ; Endoscopy, Gastrointestinal/adverse effects* ; Humans ; Intestinal Obstruction/etiology ; Intestinal Obstruction/surgery* ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Palliative Care/methods* ; Postoperative Complications* ; Proportional Hazards Models ; Retrospective Studies ; Stents/adverse effects* ; Survival Rate ; Time ; Treatment Outcome
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Lee, Hyun Jung(이현정)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
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