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    • Division of Cancer, Diagnostics and Clinical Support
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    'Real-world' experience of colonic stents for obstructive colon cancer-feasible and safe with low morbidity and mortality

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    Abstract
    Aim: To define the 'real-world' incidence of technical and clinical success, morbidity and mortality in consecutive patients undergoing self-expanding metallic stent (SEMS) implantation for obstructive colonic cancer. Method: Retrospective review of 163 patients undergoing SEMS at two centres (Royal Derby Hospital, UK and Chesterfield Royal Hospital, UK) between 2008 and 2016 cross-referenced with electronic databases for accuracy. Results: 163 patients received a total of 188 SEMS over a 99 month. The mean age was 72 (range 26-102). 82 (49.5%) presented with features of acute or sub-acute obstruction, 37 (22.7%) as a surgical emergency, 8 (5%) with fistulating tumors and 12 (7.4%) received SEMS as a bridge to semi-elective curative surgery. There were high rates of technical and clinical success (89% and 88% respectively) with a low overall incidence of complications (3.2%). Major complications included 2 (1.1%) early (<1 month) stent migrations, 4 (2.1%) perforations (day 0, 5 and 12) but no significant haemorrhage. Overall major complication rate of 6/188 (3.2%). Delayed stent migration (>1 month) occurred in 2 patient. Overall 10 procedures (6.1%) were abandoned for various reasons including that the lesion could not be crossed. Information on overall 30 day mortality (1/96, 1.04%) was available at Royal Derby Hospital. Conclusion: In this large 'real-world' case series SEMS was technically feasible with high levels of technical and clinical success and low 30-day morbidity and mortality. These results support the positive findings of randomised trials and the use of SEMS for palliation and in selected patients prior to staged surgical resection.
    URI
    https://orda.derbyhospitals.nhs.uk/handle/123456789/1371
    Collections
    • Cancer [55]
    Date
    2017-10
    Author
    Liptrot, S
    Singh, Rajeev
    Tou, Samson
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