Colorectal stenting in cancer patients

Abstract

Background. Malignant colonic obstruction (MCO) it is one of the most common and severe complications of colon and rectal cancer. The mechanisms underlying MCO development include impairments in motor, secretory and resorptive functions of the intestine, disorders of water-electrolyte metabolism, endotoxicosis, and compartment syndrome. All of these conditions significantly reduce patient survival.Objective: to compare the outcomes of colonic stenting in patients with primary and secondary tumors and to assess the efficacy of surgical treatment.Material and methods. This retrospective study included 149 patients with MCO caused by both primary colon tumors and secondary compression or extra-colon tumors. All patients underwent X-ray guided colonic stenting in the N.N. Blokhin National Medical Research Center of Oncology between 2013 and 2017.Results. Primary technical success was achieved in 143 (96 %) patients, whereas overall technical success (including restenting) was achieved in 144 (96.6 %) patients. A total of 121 (84 %) patients demonstrated complete clinical success, while 23 (15.98 %) patients had partial clinical success. The efficacy of stenting was significantly higher in patients with primary colorectal cancer than in patients with secondary lesions of the colon (96.7 % vs. 27.3 %; p <0.0001).Conclusion. Stenting is a safe and effective method of comprehensive treatment for patients with colon cancer and signs of MCO. It expands the scope of palliative care for disseminated cancer. However, in patients with extra-organ compression and secondary lesions of the colon, this procedure remains largely ineffective.