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Comparison of Wallstent and Ultraflex stents for palliation of malignant left-sided colon obstruction: a retrospective, case-matched analysis
- Source :
- Gastrointestinal Endoscopy. 67:478-488
- Publication Year :
- 2008
- Publisher :
- Elsevier BV, 2008.
-
Abstract
- Background Self-expandable metal stents (SEMSs) are accepted palliation for malignant colon obstruction. Outcomes of different stent types is unknown. Objective Our purpose was to compare outcomes after palliative placement of the Enteral Wallstent (EW) and the Precision Colonic Ultraflex (PCU) stent. Design Retrospective study of all SEMS placement during a 7-year period. Setting Tertiary care academic medical center. Patients Malignant left-sided colon obstruction in which through-the-scope (TTS) or non-TTS stent placement was possible. Main Outcome Measurements Technical and clinical success rates, stent-related complications, reintervention. Results Demographics, degree, site, and cause of obstruction were comparable. Technical difficulties were more frequent with EW than PCU (16% vs 9%, P not significant), insufficient stent expansion and stent misplacement being most common. Relief of obstruction occurred in all patients when placement was technically successful. Mean follow-up was 93 days (range 7-691 days). Early ( P not significant) and migration (4% vs 0%, P not significant) occurred more frequently in the EW group. Self-limited hematochezia was more common with PCU (20% vs 2%, P = .002). Delayed complications (perforation, stent occlusion, migration, and erosion) occurred significantly more often in the EW group (38% vs 20%). Reintervention was needed more frequently for EW, endoscopic (40% vs 17%, P = .01) and operative (46% vs 26%, P = .03). Conclusions Enteral Wallstents and Precision Ultraflex Colonic stents adequately relieve colonic obstruction. Stent dysfunction, stent-related complications, and need for reintervention are higher after EW placement. Precision Colonic Ultraflex stents appear better suited for palliation of left-sided malignant colon obstruction.
- Subjects :
- Adult
Male
medicine.medical_specialty
Palliative care
Adolescent
medicine.medical_treatment
Perforation (oil well)
Enteral administration
Left sided
Cohort Studies
Prosthesis Implantation
Colonic Diseases
Humans
Medicine
Radiology, Nuclear Medicine and imaging
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Carcinoma
Palliative Care
Gastroenterology
Stent
Retrospective cohort study
Equipment Design
Middle Aged
equipment and supplies
Hematochezia
Surgery
Treatment Outcome
Female
Stents
medicine.symptom
Colorectal Neoplasms
business
Intestinal Obstruction
Cohort study
Subjects
Details
- ISSN :
- 00165107
- Volume :
- 67
- Database :
- OpenAIRE
- Journal :
- Gastrointestinal Endoscopy
- Accession number :
- edsair.doi.dedup.....c198ee518bfdff154d6addd43e96dca2