Severity of initial stent angulation predicts reintervention after successful palliative enteral stenting for malignant luminal obstruction

Eric Y T Lee, Michael J. Bourke*, Stephen J. Williams, Ahmad Alrubaie, Vu Kwan, Adam A. Bailey, Paul M. Lynch, Sze M. Loh

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background and Aim: Recurrent stent obstruction necessitating reintervention is problematic and incompletely understood. The aim of the present study was to identify factor(s) predisposing to reintervention. Methods: Retrospective review of patients (n=117) referred to a single major endoscopic referral centre for palliative enteral stenting from 1999 to 2006. Twelve were excluded due to inadequate follow-up data (n=7) or initial radiographic documentation (n=5). A total of 105 patients (gastroduodenal n=57, colonic n=48) were therefore analyzed. The primary outcome of interest was recurrent obstruction necessitating reintervention. Kaplan-Meier analysis of potential factors predisposing to reintervention, including stent angulation (mild [<15°], moderate [15°-90°], severe [>90°]) was completed for 98 patients (technically successful enteral stenting). Results: Technical and clinical success were achieved in 98 of 105 (93.3%) and 92 of 98 (93.9%) cases, respectively. Post-stenting median survival was 97.5days (range 3-1054). Eighteen patients (18.4%) required reintervention for stent obstruction at a median time to reintervention of 85days (range 7-481). Increased stent angulation (severe vs mild hazard ratio 6.73 (95% confidence interval 1.59-27.59), P=0.009) was the only statistically significant factor in multivariate analysis predicting reintervention. Conclusions: Despite its limitation as a retrospective review, this study found that reintervention for stent obstruction is necessary in almost one in five cases, and increasing severity of stent angulation is the most important risk factor.

Original languageEnglish
Pages (from-to)484-491
Number of pages8
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume26
Issue number3
DOIs
Publication statusPublished - 2011
Externally publishedYes

Keywords

  • Colonoscopic surgical procedures
  • Colorectal cancer
  • Gastric cancer
  • Gastroscopic surgical procedures
  • Intestinal obstruction
  • Pancreatic cancer
  • Stents

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