Assessment of Endoscopic Colonic Stenting Outcomes in Patients with Acute Malignant Colonic Obstruction

Background: The traditional method of treating patients with acute malignant colonic obstruction (AMCO) is emergency surgery, which is often accompanied by the development of severe complications and high mortality. Endoscopic colonic stenting with self-expandable metal stents (SEMS) is a promising way to treat such patients. However, its capabilities are not yet fully explored. We present a cross-sectional study with endoscopic colonic stenting using SEMS in AMCO patients, treated from ۲۰۱۶-۲۰۲۰ to clarify and identify the factors that may influence the result.Methods. Our study included ۲۱۸ patients with AMCO in whom surgeons attempted to eliminate acute colonic obstruction using endoscopic stenting. The capabilities of endoscopic stenting were assessed based on calculated technical and clinical efficacy, complications, and mortality. The patients were divided into two groups namely the clinical success group (۱۸۲ patients) and the clinical failure group (۳۶ patients). Results: The results showed that the technical efficiency of endoscopic stenting of the colon was ۹۱.۷%, and its clinical efficiency was ۸۳.۵%. The incidence of intra-abdominal complications was ۸.۳%, the incidence of somatic complications was ۱۱.۹%, and mortality was ۵%. Comparative analysis of the groups revealed significant differences ( P<۰.۰۵) for the oncological process stage, the duration, and the severity of intestinal obstruction.Conclusion: Endoscopic stenting of the colon with SEMS is an effective way to treat patients with AMCO. The success rate may vary depending on the severity of trophic disorders in the intestinal wall.

Keywords:

Сolorectal cancer , Large bowel obstruction , Self-expanding stents