Endoscopy 2020; 52(S 01): S103
DOI: 10.1055/s-0040-1704316
ESGE Days 2020 oral presentations
Friday, April 24, 2020 14:30 – 16:30 Keeping the lumen Liffey Meeting Room 2
© Georg Thieme Verlag KG Stuttgart · New York

RISK FACTORS OF FAILURE AND COMPLICATIONS FOR ENDOSCOPIC COLORECTAL STENTING

A Vodoleev
1   National Medical Research Center of Radiology, Endoscopy, Moscow, Russian Federation
2   RUDN University, Department of Endoscopy, Endoscopic and Laser Surgery, Moscow, Russian Federation
3   Eramishantsev Clinical Hospital, Endoscopy, Moscow, Russian Federation
,
D Kriazhev
3   Eramishantsev Clinical Hospital, Endoscopy, Moscow, Russian Federation
,
V Duvanskiy
2   RUDN University, Department of Endoscopy, Endoscopic and Laser Surgery, Moscow, Russian Federation
,
S Pirogov
1   National Medical Research Center of Radiology, Endoscopy, Moscow, Russian Federation
,
I Perfil’ev
1   National Medical Research Center of Radiology, Endoscopy, Moscow, Russian Federation
,
E Karpova
1   National Medical Research Center of Radiology, Endoscopy, Moscow, Russian Federation
,
D Sukhin
1   National Medical Research Center of Radiology, Endoscopy, Moscow, Russian Federation
,
V Veselov
1   National Medical Research Center of Radiology, Endoscopy, Moscow, Russian Federation
,
T Belyaeva
1   National Medical Research Center of Radiology, Endoscopy, Moscow, Russian Federation
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Stenting is an effective method of decompression for patients with malignant colorectal obstruction. Widespread adoption is resticted due to relatively high rate of failure and complications. Аccording to publications, we have very limited and unsystematic data about risk factor. The aim of our study was to analyze the factors influencing the occurrence of failure and complications after colorectal stenting.

Methods We carefully studied cases of 242 patients with malignant colorectal obstruction who received endoscopic SEMS insertion from December 2012 to September 2019.

Results The technical success rate was 92.3%. Insufficient experience in performing ERCP and stenting (less than 50 and 25 interventions) and use of standard intervention techniques(colonoscope + catheter with guidewire) were risk factors for failure (odd ratio 4.229; 95% CI, 1.356-13.189). After successful procedure, in 12 (5.1%) patients perforation was recognized on 1-20 days. One patient has silent perforation (intraoperative finding), in 1 case - autopsy finding. Severe obstructive symptoms (11-15 points on the Colon Obstruction Score (odd ratio 7.2432; 95% CI, 1.040-28.787) and 0-1 on the CROSS scale odd ratio, (odd ratio 4.439; 95% CI, 0.48-0.59) were perforation-related factors for the entire sample of cases. Additionally, stage T4b was risk factor of tumor perforations (odd ratio 7.87; 95% CI, 2.040-12.508), and cecum dilatation on X ray more 10 cm was significantly associated with occurrence of perforation in right colon (odd ratio 2.602; 95% CI, 1.279 - 5.634). We did not find statistically significant risk factors associated with stent migration and ingrowth.

Conclusions SEMS placement remains operator dependent intervention and should be performed by an expert endoscopist. It´s necessary to conduct trainings in reference centers. Severity of obstructive symptoms was significantly associated with occurrence of perforation. In order to reduce perforation rate, clinicians should pay more attention when performing SEMS placement and monitoring patients with these risk factors.