Incurable stenosing colorectal carcinoma: Endoscopic stent implantation or palliative surgery?

被引:33
|
作者
Ptok, Henry
Marusch, Frank
Steinert, Ralf
Meyer, Lutz
Lippert, Hans
Gastinger, Ingo
机构
[1] Carl Thiem Hosp, Dept Surg, D-03048 Cottbus, Germany
[2] Univ Hosp, Dept Gen Visceral & Vasc Surg, D-39120 Magdeburg, Germany
关键词
D O I
10.1007/s00268-005-0513-z
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background. Palliative surgery for the treatment of incurable obstructive colorectal carcinoma is associated with a considerable perioperative morbidity and mortality but no substantial improvement of the prognosis. The aim of the present study was to study the effectiveness of colorectal stenting compared with palliative surgery in incurable obstructive colorectal carcinoma. Patients and Methods: From April 1999 to April 2005, data of consecutive patients with incurable stenosing colorectal carcinoma, either treated with stent implantation or palliative surgical intervention, were prospectively recorded with respect to age, sex, tumor location (including metastases), ASA-score, peri-interventional morbidity, mortality, rates of complications, and reinterventions as well as survival. Results: Of 40 patients, 38 (95%) were successfully treated with a stent. Two patients (5%) underwent surgical intervention after stent dislocation. In contrast, 38 patients primarily underwent palliative surgical intervention. Stent patients were significantly older (P = 0.020), had a higher ASA-score (P = 0.012), and had more frequently distant metastases (P = 0.011). After successful stent implantation, no early complications were observed, but late complications occurred in 11 subjects (29%). Following palliative surgical intervention, postoperative complications occurred in 12 individuals (32%). Postoperative mortality was 5% in the surgery group, whereas no patient died following stent implantation. There was no significant differences in the survival of both groups (9.9 vs. 7.8 months, respectively; log rank: 0.506). Conclusions: Palliative treatment of incurable obstructive colorectal carcinoma using stents is an effective and suitable alternative to palliative surgery with no negative impact on the survival but less peri-interventional morbidity and mortality as well as comparable overall morbidity.
引用
收藏
页码:1481 / 1487
页数:7
相关论文
共 50 条
  • [21] COMPARISON OF LAPAROSCOPIC VERSUS OPEN PALLIATIVE SURGERY FOR PATIENTS WITH INCURABLE STAGE IV COLORECTAL CANCER.
    Kim, J.
    Park, J.
    Park, S.
    Choi, H.
    Kim, S.
    Baek, J.
    Oh, J.
    DISEASES OF THE COLON & RECTUM, 2013, 56 (04) : E277 - E277
  • [22] Palliative treatment for incurable malignant colorectal obstructions: a meta analysis
    Zhao, Xiaodan
    Cai, Baobao
    Cao, Risheng
    Shi, Ruihua
    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2013, 28 : 898 - 898
  • [23] Palliative treatment of malignant esophageal stenosis: the role of self-expanding stent endoscopic implantation
    Mosca, F
    Stracqualursi, A
    Portale, TR
    Consoli, A
    Latteri, S
    DISEASES OF THE ESOPHAGUS, 2000, 13 (04) : 301 - 304
  • [24] In stent stenosis in paediatric patients following palliative stent implantation
    Michel-Behnke, I
    Hagel, KJ
    Akintürk, H
    Bauer, J
    Schranz, D
    Kreuder, J
    EUROPEAN HEART JOURNAL, 2001, 22 : 354 - 354
  • [25] Palliative treatment for incurable malignant colorectal obstructions: A meta-analysis
    Xiao-Dan Zhao
    Bao-Bao Cai
    Ri-Sheng Cao
    Rui-Hua Shi
    World Journal of Gastroenterology, 2013, 19 (33) : 5565 - 5574
  • [26] INCIDENCE OF BACTEREMIA FOLLOWING ENDOSCOPIC LASER TREATMENT OF STENOSING COLORECTAL LESIONS
    KOHLER, B
    GINSBACH, C
    RIEMANN, JF
    GASTROINTESTINAL ENDOSCOPY, 1988, 34 (01) : 73 - 74
  • [27] To Stent or Not to Stent?: Palliative Management of Inoperable Colorectal Cancer Response
    Fernandez-Esparrach, Gloria
    Maria Bordas, Josep
    AMERICAN JOURNAL OF GASTROENTEROLOGY, 2010, 105 (05): : 1209 - 1210
  • [28] Self-expandable metallic stent placement as palliative treatment of obstructed colorectal carcinoma
    Iruru Maetani
    Tomoko Tada
    Takeo Ukita
    Hirokazu Inoue
    Mitsuhiro Yoshida
    Yoshihisa Saida
    Yoshihiro Sakai
    Journal of Gastroenterology, 2004, 39 : 334 - 338
  • [29] Palliative treatment for incurable malignant colorectal obstructions: A meta-analysis
    Zhao, Xiao-Dan
    Cai, Bao-Bao
    Cao, Ri-Sheng
    Shi, Rui-Hua
    WORLD JOURNAL OF GASTROENTEROLOGY, 2013, 19 (33) : 5565 - 5574
  • [30] Self-expandable metallic stent placement as palliative treatment of obstructed colorectal carcinoma
    Maetani, I
    Tada, T
    Ukita, T
    Inoue, H
    Yoshida, M
    Saida, Y
    Sakai, Y
    JOURNAL OF GASTROENTEROLOGY, 2004, 39 (04) : 334 - 338