Combination endo-radiological colorectal stenting: a prospective 5-year clinical evaluation

Objective Self-expanding metallic stents have found increasing use in the palliation of malignant large-bowel obstruction or as a 'bridge to surgery' to facilitate a planned operative procedure. We describe a 5-year experience of using the combined endoscopic/fluoroscopic through-the-scope method of stent placement in a tertiary referral centre. Method A prospective database of patients referred for colorectal stenting was compiled. Technical success, clinical success (decompression) and procedure-related complications were measured as end-points. Results Sixty-three patients underwent 71 stenting procedures; 39 (62%) patients were male and the median age of patients was 78 years; 32 patients had metastatic disease and seven strictures were due to extrinsic compression. The indication for stenting was palliation in 56 patients and preoperative in seven patients. There was a technical success rate of 91% and a clinical success rate of 89%. Complications occurred in 24% of the cohort: overgrowth, (8%), migration (6%), fistulation (4%), stent fracture (3%), tenesmus (3%) and faecal urgency (1%). There was no procedure-related death within the cohort and no technical failures proximal to the descending colon. Conclusion Combination endoscopic/fluoroscopic colorectal stenting is effective and safe. It may be particularly useful in the stenting of more proximal colonic strictures.