The role of palliative colorectal stents in gynaecologic malignancy

Objective. The objectives of this study were to determine the clinical success of colorectal stenting in patients with large bowel obstruction secondary to gynaecologic malignancy and to determine whether there are any predictors of outcome. Methods. This was a retrospective cohort study of all patients with a gynaecologic malignancy and large bowel obstruction referred for colorectal stenting at Vancouver General Hospital between January 2006 and February 2013. All stents were placed using image guidance with the exception of one placed endoscopically. Information was extracted from the medical record. Data were analysed using descriptive statistics. Chi-square and Fisher's exact tests were used to compare stent outcomes and clinical variables. Results. There were 32 patients in the study. The median age was 66 (range 40-78). The median follow-up was 28.9 months (range 0.8-481). The primary tumour was ovarian in 75% and uterine in 18.8%. Seventy-five percent of patients had a technically successful stent insertion. Of these, 37.5% had a complication requiring intervention. The rate of clinical success was 47%. There were no statistically significant associations between any clinical variables and failed stent insertion or complications. Conclusion. Colorectal stenting in patients with a large bowel obstruction secondary to gynaecologic malignancy is associated with a high rate of technical success but a low rate of clinical success. There were no clinical predictors of outcome identified in this study. If patients are offered this procedure, they should be counselled about the anticipated benefit and associated risks. (C) 2014 Elsevier Inc. All rights reserved.