Journal List > J Korean Soc Radiol > v.62(3) > 1086722

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Kang, Hong, Choi, Lee, Park, Chung, and Kim: Self-Expandable Metallic Stent for the Palliative Treatment of Obstructing Left-Sided Colorectal Cancer under Fluoroscopic Guidance: A Comparison of the Clinical Results according to Stent Diameter
Interventional Radiology
Original Article

Journal of the Korean Society of Radiology 2010; 62(3): 219-225.

Published online: 31 March 2010

DOI: https://doi.org/10.3348/jksr.2010.62.3.219

Self-Expandable Metallic Stent for the Palliative Treatment of Obstructing Left-Sided Colorectal Cancer under Fluoroscopic Guidance: A Comparison of the Clinical Results according to Stent Diameter

Pyeong Guk Kang, M.D., Hyun Pyo Hong, M.D.1, 2, Yoon Jung Choi, M.D., Min Hee Lee, M.D., Hae Won Park, M.D., Eun Chul Chung, M.D., Sam Soo Kim, M.D.2

1Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Korea.

2Department of Radiology, Kangwon National University College of Medicine, Korea.

Address reprint requests to: Hyun Pyo Hong, M.D., Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108, Pyung-dong, Jongro-gu, Seoul 110-746, Korea. Tel. 82-2-2001-1031, Fax. 82-2-2001-1030, summerson@paran.com

Received 23 September 2009       Accepted 20 October 2009

Copyright © 2010 The Korean Society of Radiology

Abstract

Purpose

To evaluate the feasibility, effectiveness, and safety of self-expandable metallic stent for the palliative treatment of obstructing left-sided colorectal cancer under fluoroscopic guidance, and to compare results according to the stent diameter.

Materials and Methods

Under fluoroscopic guidance, 31 self-expandable metallic stents were placed into 25 patients for palliative purposes. The rates of technical success, clinical success, complications associated with stent insertion, patient survival, and primary stent patency were evaluated. The results were also compared between two groups: 13 patients using stents with a diameter of 22 mm and 12 patients using stents with a diameter of 26 mm.

Results

The technical and clinical success rates were 93.5 and 90.3%, respectively. The complications included severe abdominal pain (6.5%), minor rectal bleeding (9.7%), stent migration (9.7%), and tumor ingrowth or overgrowth (9.7%). No statistical differences in technical were detected between the two groups for the clinical success rate and complication rates. The mean survival time was 5.5 ± 1.4 months. The primary stent patency rates were 91.3% at 5 months, 85.2% at 10 months, and 77.4% at 15 months. The mean period of stent patency was 12.4 ± 2.6 months. The mean period of primary stent patency was 16.4 ± 2.6 months in the 26 mm stent group, and significantly higher than 5.4 ± 1.4 months in the 22 mm stent group (p=0.031).

Conclusion

A self-expandable metallic stent under fluoroscopic guidance, for the palliative treatment of obstructing left-sided colorectal cancer, was feasible and effective, and yielded good clinical results. The period of primary stent patency of the 26 mm stent group was longer than the 22 mm stent group, and the complication rate was not significantly different between the two stent groups.

Keywords: Radiology, Interventional, Stents, Colorectal Neoplasms

Figures and Tables

Fig. 1

59-year-old women. Coronal reformatted CT image (A) show asymmetric wall thickening at distal portion of descending colon (arrows). Multiple hepatic metastasis also noted. Endoscopic biopsy proved adenocarcinoma. 26 mm × 10 cm, covered stent inserted successfully (B). 3 months later, coronal reformatted CT image (C) show increased tumor extent to proximal portion of stent (arrows). Additional 26 mm × 12 cm, noncovered stent inserted successfully (arrows) (D).

jksr-62-219-g001
Fig. 2

Graph shows cumulative primary patency rate of 22 mm stent group and 26 mm stent group.

jksr-62-219-g002
Table 1

Demographics and Stent Characteristics of 25 Patients

jksr-62-219-i001

* Unless otherwise specified, data are numbers of cases, with percentages in parentheses.

Table 2

The Summary of Results of 31 Fluoroscopic Placement of Self-Expandable Metallic Stent as a Palliative Treatment for 25 Patients

jksr-62-219-i002

* Unless otherwise specified, data are numbers of cases, with percentages in parentheses.

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