Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

A Japanese Prospective, Multicenter Study of Colonic Stenting for Palliation Using a High Axial Force Self-Expandable Metal Stent for Malignant Large Bowel Obstruction in 200 Patients

Rei Ishibashi
ORCID logo ,
Takashi Sasaki
ORCID logo ,
Hiroyuki Isayama
* ORCID logo ,
Takeaki Matsuzawa
,
Toshio Kuwai
ORCID logo ,
Tomonori Yamada
,
Shuji Saito
ORCID logo ,
Masafumi Tomita
,
Toshiyasu Shiratori
,
Satoshi Ikeda
,
Hideki Kanazawa
,
Mitsuhiro Fujishiro
,
Iruru Maetani
ORCID logo ,
Yoshihisa Saida
Version 1 : Received: 23 May 2023 / Approved: 25 May 2023 / Online: 25 May 2023 (03:11:04 CEST)

A peer-reviewed article of this Preprint also exists.

Ishibashi, R.; Sasaki, T.; Isayama, H.; Matsuzawa, T.; Kuwai, T.; Yamada, T.; Saito, S.; Tomita, M.; Shiratori, T.; Ikeda, S.; Kanazawa, H.; Fujishiro, M.; Maetani, I.; Saida, Y. A Japanese Prospective, Multicenter Study of Colonic Stenting for Palliation Using a High Axial Force Self-Expandable Metal Stent for Malignant Large Bowel Obstruction in 200 Patients. J. Clin. Med. 2023, 12, 5134. Ishibashi, R.; Sasaki, T.; Isayama, H.; Matsuzawa, T.; Kuwai, T.; Yamada, T.; Saito, S.; Tomita, M.; Shiratori, T.; Ikeda, S.; Kanazawa, H.; Fujishiro, M.; Maetani, I.; Saida, Y. A Japanese Prospective, Multicenter Study of Colonic Stenting for Palliation Using a High Axial Force Self-Expandable Metal Stent for Malignant Large Bowel Obstruction in 200 Patients. J. Clin. Med. 2023, 12, 5134.

Abstract

Evidence of the efficacy and safety of colorectal stent placement for palliation remains insufficient. This single-arm, prospective, multicenter study with WallFlex enteral colonic stent included 200 consecutive patients with malignant large bowl obstruction in the palliation cohort. The technical and clinical success, as well as stent patency and complications as short-term (≤ 7 days) and long-term (> 7days) outcomes, of high axial force self-expandable metal stent (SEMS) placement was evaluated. The technical and clinical success rates were 98.5% and 94.5%, respectively. Non recurrent colorectal obstruction at 1 year was 63.9%, and 71.2% of the patients remained free of recurrent colorectal obstruction until death or the last follow-up. Fifty-six patients (28.0 %) received chemotherapy and five patients were administered bevacizumab after stent placement. The overall complication rate was 47%, including four (2.0%) early-onset and ten (5.0%) late-onset perforations, mostly due to stent-edge injury. Only the use of a long SEMS was a risk factor for perforation. In conclusion, endoscopic colorectal stenting using high axial force SEMS is an effective and safe procedure for palliation in patients with malignant colorectal obstruction. However, care should be taken to avoid perforation at the stent edge when using a long SEMS.

Keywords

axial force; chemotherapy; malignant colorectal obstruction; palliation; self-expandable metal stent

Subject

Medicine and Pharmacology, Gastroenterology and Hepatology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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