Endoscopy 2020; 52(S 01): S187
DOI: 10.1055/s-0040-1704581
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ANALYSING OUTCOMES FROM ELECTIVE COLONIC STENTING FOR COLORECTAL CANCER AT A DISTRICT GENERAL HOSPITAL

D Mohandas
1   East and North Hertfordshire NHS Trust, Gastroenterology, Stevenage, United Kingdom
,
A Sinha
1   East and North Hertfordshire NHS Trust, Gastroenterology, Stevenage, United Kingdom
,
S Tewari
1   East and North Hertfordshire NHS Trust, General Surgery, Stevenage, United Kingdom
,
MM San
1   East and North Hertfordshire NHS Trust, Gastroenterology, Stevenage, United Kingdom
,
R Mead
1   East and North Hertfordshire NHS Trust, Gastroenterology, Stevenage, United Kingdom
,
S Greenfield
1   East and North Herts NHS Trust, Gastroenterology, Stevenage, United Kingdom
,
D Rowlands
1   East and North Hertfordshire NHS Trust, Gastroenterology, Stevenage, United Kingdom
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Publikationsdatum:
23. April 2020 (online)

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Aims To appraise outcomes for cases of elective Colonic stenting at our District General Hospital.

Methods In this retrospective study, cases of elective colonic stenting for Colorectal cancer over a 4 year period from 1/12/2015 to 1/12/2019 were identified via CIPTS (Delian system)an online database of endoscopy procedures.For identified patients,further demographics(age,sex) and outcome measures relating to procedure complications,30day mortality, intervention location and types of stent used were also collected.

Results Overall 29 individual patients underwent Colonic stenting with Boston Scientific Wireflex stents performed by three operators.A total of 30 procedures occurred as a case of stent migration requiring revision.Among this population, the mean age was 79.2yrs with a range between 41-98 and a slight female preponderance (N=15,51.7%).Overall 30 day mortality was 10.34%(N=3) whilst 90 day survival was 75.9% (N=22).One patient had stenting as a bridge to surgical intervention.Rates of complications were low with one case of stent migration(3.4%), one case of wire perforation (3.4%) and one case of stent fracturing (3.4%) which required required no repeat intervention.Locations of therapy were predominantly for sigmoid lesions(N=17,58.6%) followed by descending colon (N=6, 20.7%), splenic flexure (N=3,10.4%), rectum(N=2, 6.9%) and transverse colon (N=1 3.4%).

Conclusions Locally, Colonic stenting has proven an effective therapy for patients with Colorectal cancer with low rates of complications compared with previous meta-analysis data1.Local 30 day mortality is higher than previously reported rates but comparable to previous data on Emergency surgical procedures1.The financial implications of surgery and post-op care are also negated with only one patient requiring admission post-stenting among our cohort.Interestingly 90 day survival was promising, considering many patients had significant comorbidities of metastatic disease at the time of stenting. We aim to use this as a platform to expand stenting services and appraise emergency stenting.

 

  • References

  • 1 Zhao XD, , Cai BB, , Cao RS. et al. Palliative treatment for incurable malignant colorectal obstructions..
    PubMed