Document Type : Original Article
Sechenov First Moscow State Medical University, Department of Hospital Surgery, Moscow
Department of Hospital Surgery, Sechenov First Moscow State Medical University
Endoscopy Department, Eramishantsev City Clinical Hospital
Eramishantsev City Clinical Hospital, Moscow, Russian Federation
Background: The traditional method of treating patients with acute malignant colonic obstruction (AMCO) is emergency surgery, which is often accompanied by the development of severe complications and high mortality. Endoscopic colonic stenting with self-expandable metal stents (SEMS) is considered a promising way to treat such patients. However, its capabilities are not yet fully explored. This paper presents a cross-sectional study of the results of endoscopic colonic stenting using SEMS in AMCO patients, performed in 2016-2020 to clarify and identify the factors that influence its result.
Methods. The study included 218 patients with AMCO in whom surgeons attempted to eliminate the acute colonic obstruction using the method of endoscopic stenting. The capabilities of endoscopic stenting were assessed based on calculated technical and clinical efficacy, the incidence of complications, and mortality. All patients were divided into two groups clinical success group (182 patients) and clinical failure group (36 patients). The groups were subjected to comparative analysis.
Results: The results showed that the technical efficiency of endoscopic stenting of the colon was 91.7%, and its clinical efficiency was 83.5%. Also, the incidence of intra-abdominal complications was 8.3%, the incidence of somatic complications was 11.9%, and the mortality was 5%. Comparative analysis of the groups revealed significant differences (with p<0.05) for the oncological process stage, the duration, and the severity of intestinal obstruction.
Conclusion: Endoscopic stenting of the colon with SEMS is an effective way to treat patients with AMCO. Its success can vary depending on the severity of trophic disorders in the intestinal wall.