Comparison of different types of covered self-expandable metal stents for malignant colorectal obstruction
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and Other Interventional Techniques
Comparison of different types of covered self‑expandable metal stents for malignant colorectal obstruction Joon Seop Lee1 · Hyun Seok Lee1 · Eun Soo Kim1 · Min Kyu Jung1 · Jin Tae Jung2 · Ho Gak Kim2 · Dong Wook Lee2 · Dae Jin Kim3 · Yoo Jin Lee4 · Chang Heon Yang5 on behalf of Daegu-Gyeongbuk Gastrointestinal Study Group (DGSG) Received: 8 May 2020 / Accepted: 5 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Stent migration is one of the main drawbacks of covered self-expandable metal stent (SEMSs), occurring in up to 40% of malignant colorectal obstruction management cases. Various types of covered SEMSs have been developed to reduce this risk. We aimed to compare the effectiveness and complication rates of the flare-type covered SEMS (Flare) with those of the double-layered covered SEMS (ComVi). Methods We performed a prospective, randomized study in four tertiary referral centers between July 2016 and April 2018. Patients with malignant colorectal obstruction were eligible for the study. The primary outcome was migration rate as observed within the first month. Rates of technical success, clinical success, and complications within the first month were also assessed. Results A total of 60 patients were included (mean age, 70.5 ± 12.5 years; male, 31 [51.7%]). Flare and ComVi stents were applied in 30 patients each. The Flare and ComVi groups showed comparable technical success rates (90% [27/30] vs. 96.7% [29/30], p = 0.605) and clinical success rates (85.2% [23/27] vs. 75.9% [22/29], p = 0.589). Migration occurred in three (11.1%) and four (13.8%) cases in the Flare and ComVi groups, respectively, without significant difference (p = 0.99), and the risk of other complications, including perforation and re-obstruction, did not differ between the two groups. Conclusions Our study indicates that both flare-shape and double-layered covered SEMSs are equally effective options for the management of malignant colorectal obstruction with low migration rates when compared with previously reported migration risk of covered SEMS. Keywords Colorectal malignant obstruction · Covered stents · Migration
Joon Seop Lee and Hyun Seok Lee contributed equally to this work. * Eun Soo Kim [email protected] 1
Department of Internal Medicine, Kyungpook National University School of Medicine, Kyungpook National University Hospital, Daegu, South Korea
2
Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
3
Department of Internal Medicine, Fatima Hospital of Daegu, Daegu, South Korea
4
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
5
Department of Internal Medicine, Dongguk University School of Medicine, Gyeongju, South Korea
Colorectal cancer (CRC) is a common malignancy in developed countries. Approximately 20% of patients with CRC present with malignant obstruction at the time of diagnosis [1]. Colorectal obstruction can le
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