The Role of Primary Colectomy After Successful Endoscopic Stenting in Patients With Obstructive Metastatic Colorectal Cancer

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Although the initial clinical efficacy of self-expandable metal stents is acceptable, doubt still remains about long-term clinical outcomes and complications.


The aim of this study was to evaluate the stoma formation rate and risk factors for complications after successful stenting in patients with obstructive metastatic colorectal cancer.


This was a tertiary-care center retrospective study.


From January 2000 to December 2010, 130 patients with unresectable obstructive colorectal cancer received successful self-expandable metal stent placement. Among them, 14 patients received primary colectomy after successful stenting.


Self-expandable metal stent placement and primary colectomy were performed.


The stoma formation rate and complications were measured.


In patients with successful stenting, stoma formation rates at 1 and 2 years were 15.6% (95% CI, 8.74–22.4) and 24.4% (95% CI, 13.8–35.0), and the median patency duration was 157 days (range, 2–1590 days). However, long-term complications occurred in 58 patients (44.6%), including reobstruction (32.6%), stent migration (10.3%), and perforation (7.8%), and a large number of reinterventions (45.7%) and hospitalizations (37/9%) were needed to manage complications. In multivariate analysis, primary colectomy after successful endoscopic stenting was a negative predictive factor for reobstruction (OR, 0.12; 95% CI, 0.02–0.99; p = 0.04).


This was a retrospective, single-center study.


To reduce stent-related late complications, primary colectomy after successful endoscopic stenting could be a therapeutic option in patients who have unresectable colorectal cancer with obstruction, especially in those who expect long-term survival.

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