Colonic Stenting; Indication and Outcomes in a Single Health and Social Care Trust

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Introduction

Colonic stenting is a recognised treatment of acute and subacute obstruction in benign and malignant strictures.

Aims

To assess the efficacy, outcomes and safety of colonic stent placement within the Southern Health and Social Care Trust, Northern Ireland.

Methods

A retrospective review of all colonic stents inserted between May 2005-January 2017 in the Southern Trust was performed. The indication, technical success, complications and outcomes were analysed.

Results

59 patients underwent a total of 62 colonic stents. 9 were emergency procedures and 53 were elective. 54 (87%) were inserted for colorectal cancer, 7 (11%) for benign strictures, and 1 (2%) for an invading ovarian tumour. From the stents inserted for malignancy, 50 (81%) were for palliation and 5 (8%) as a bridge to surgery. The technical success rate was 90.3%. In 3 cases failure was due to the inability to pass the stricture, 1 due to difficult anatomy, and 1 tumour too close to the dentate line. Complications included 2 (3.2%) perforations, 6 (9.8%) stent migrations, and 3 (4.8%) developed tumour overgrowth. 39 (63%) stents did not require further intervention. 23 (37%) required further procedures of either stenting or surgery, and two (3%) of these were performed as an emergency. Six (9.7%) patients died within 30 days, however no patient died as a complication of stent placement.

Conclusion

Within our department, colonic stenting has been shown to be an effective and safe procedure. It reduces the number of patients requiring surgical intervention and provides successful palliation of colonic obstruction.