Endoscopy 2019; 51(04): S129-S130
DOI: 10.1055/s-0039-1681552
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 10:30 – 11:00: Colon stent ePoster Podium 2
Georg Thieme Verlag KG Stuttgart · New York

THE PROGNOSTIC IMPACT OF BOWEL PERFORATION FOLLOWING SELF-EXPANDABLE METAL STENT AS A BRIDGE TO SURGERY FOR MALIGNANT COLORECTAL OBSTRUCTION

, , A Research Group for Endoscopic Instruments and Stents (REIS)
BI Lee
1   Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of
,
TH Kwon
1   Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of
,
Y Choe
1   Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of
,
HH Lee
1   Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of
,
H Lim
2   Division of Gastroenterology, Department of Internal Medicine, University of Hallym College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea, Republic of
,
YM Park
3   Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea, Republic of
,
JW Kim
3   Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea, Republic of
,
SE Hyeon
4   Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea, Republic of
,
Y Jung
4   Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea, Republic of
,
SW Han
1   Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Although Self-expandable metal stent (SEMS) is very useful for relieving malignant colorectal obstruction, it may cause bowel perforation and result in impaired oncological outcomes. However, data comparing the outcomes of patients with or without perforation are limited. We aimed to compare overall survival and recurrence rates depending on SEMS-related bowel perforation.

Methods:

This multicenter study included obstructive colorectal cancer patients treated with SEMS as a bridge to surgery. The data were retrospectively collected and the patients were matched at a ratio of 1:5 according to age, sex, tumor location, pathologic stage, and curative resection. The oncological outcomes according to perforation were evaluated using the Kaplan-Meier method.

Results:

From January 2009 to February 2018, 258 patients underwent SEMS as a bridge to surgery. Of these patients, 18 (7.0%) had SEMS-related perforations (the perforation group). Overt and silent perforations were identified in 16 and 2, respectively. The rate of more than 14 cm of SEMS length was higher in the perforation group compared the entire patients without perforation (16.7% vs. 2.5%, p = 0.019 by Fisher's exact test). In comparison with 90 matched controls (the non-perforation group), the 5-year overall survival rate was lower in the perforation group (54.3% vs. 77.2%, p = 0.078). The 5-year recurrence rate was significantly higher in the perforation group compared the non-perforation group (50.1% vs. 23.6%, p = 0.003).

Conclusions:

Insertion of longer SEMS increases the risk of perforation. SEMS-related perforation is associated with increased recurrence rate.