Background
Surgical management of patients with metastatic or recurrent rectal cancer remains
controversial. Self-expanding metal stents are increasingly used for palliative treatment
of advanced tumors, although long-term results are not yet available.
Methods
Between 1996 and 2003, 521 patients underwent surgery for rectal neoplasms. In the
same time period, self-expanding metal stents were used for palliation of 34 patients
with malignant rectal obstruction and incurable disease. The outcome of the patients
was analyzed retrospectively.
Results
Rectal stents were successfully placed in 33 of 34 patients (97%) without major complications.
Early failure occurred in 7 patients (21%) because of stent migration, pain, or incontinence.
Long-term success with a mean patency of 5.3 months was observed in 26 patients (79%),
but restenting was required in 2 patients. Despite the initial success of stenting,
a colostomy was created in 2 other patients after 3.4 months and 9.2 months because
of incontinence and rectovesical fistula. Overall, 6 of 33 patients (18%) underwent
palliative surgery because of early complications (n = 4) or long-term failure of stent treatment (n = 2).
Conclusions
Self-expanding metal stents are useful to avoid a colostomy in selected patients with
incurable rectal cancer and limited life expectancy. Nonetheless, a considerable number
(18%) of patients will require surgical palliation because of failure of stent treatment.
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Article info
Publication history
Accepted:
May 7,
2004
Berlin, GermanyIdentification
Copyright
© 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
