Clinical Outcomes of Self-Expandable Metal Stents for Malignant Rectal Obstruction

BACKGROUND: Self-expandable metal stents are widely used to treat malignant colorectal obstruction. However, data on clinical outcomes of stent placement for rectal obstruction specifically are lacking. OBJECTIVE: We aimed to investigate the clinical outcomes of self-expandable metal stents in malignant rectal obstruction in comparison with those in left colonic obstruction and to identify factors associated with clinical failure and complication. DESIGN: This was a retrospective study. SETTINGS: The study was conducted at a tertiary care center. PATIENTS: Between January 2005 and December 2013, medical charts of patients who underwent stent placement for malignant rectal or left colonic obstruction were reviewed retrospectively. INTERVENTION: Study intervention included self-expandable metal stent placement. MAIN OUTCOME MEASURES: Technical success, clinical success, and complications were measured. RESULTS: Technical success rates for the 2 study groups (rectum vs left colon, 93.5% vs 93.1%; p = 0.86) did not differ significantly; however, the clinical success rate was lower in patients with rectal obstruction (85.4% vs 92.1%; p = 0.02). In addition, the complication rate was higher in patients with rectal obstruction (37.4% vs 25.1%; p = 0.01). Patients with rectal obstruction showed higher rates of obstruction because of extracolonic malignancy (33.8% vs 15.8%; p

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