Fluoroscopic Rescue of Failed Endoscopic Stent Placement for Obstructing Colorectal Malignancy.

Abstract

<b>OBJECTIVE.</b> This study evaluated the technical feasibility and clinical effectiveness of fluoroscopic stent placement in malignant colorectal obstructions after failed endoscopic stent placement. <b>MATERIALS AND METHODS.</b> Between January 2004 and December 2017, 41 patients with malignant colorectal obstructions were referred for fluoroscopic stent placement after failed endoscopy. The procedures were performed for palliation (<i>n</i> = 35) or as a bridge to surgery (<i>n</i> = 6). The technical and clinical success, complications, stent patency duration, and patient survival were retrospectively analyzed. <b>RESULTS.</b> Fluoroscopic stent placement was technically successful in 38 patients (92.7%). The causes of technical failure were complete obstruction (<i>n</i> = 1), redundant sigmoid colon (<i>n</i> = 1), and colon perforation (<i>n</i> = 1). Clinical success was achieved in 37 patients with technical success (97.4%). Major complications occurred in three patients (7.9%) and included colon perforation (<i>n</i> = 2) and anal pain (<i>n</i> = 1). The six patients with stenting as a bridge to surgery underwent elective colectomy uneventfully (100%). In 32 patients with technically successful palliative stenting, the median primary stent patency duration and patient survival were 353 days (95% CI, 162-353 days) and 335 days (95% CI, 116-335 days), respectively. <b>CONCLUSION.</b> Fluoroscopic colorectal stent placement is technically feasible and clinically effective in most patients with failed endoscopic procedures.