Clinical Study Of Metal Stenting For Malignant Colorectal Obstruction

0bjective: To observe and evaluate the application of endoscopic metal stenting for malignant colorectal obstruction. Analyze and compare Elective Surgery with stent placement to Emergency Surgery for malignant colorectal obstruction.Methods: A retrospective analysis contained 51cases with malignant colorectal obstruction from January 2006 to October 2008.24cases were treated with endoscopic metal stenting, 21cases of them progressed to surgery which meeting the criteria for respectability. Analyzed the rate of relief and complication after the endoscopic metal stenting. Compare the rate of onestage operation and the complication in Elective Surgery with stent placement(study group ) and Emergency Surgery(controlled group).Results: 24 cases were successfully inserted metal stents(24/24,100%),and,and showed relief of symptoms within 1-2 days. Permanent metal stent placement was performed in 3 cases for palliative treatment. 21 underwent subsequent elective surgical resection after 5-6 days. The rate of complication : perforation 0%,minor bleeding 8.3%,stent migration 4.2%,others(pain,tenesmus et.)12.5%.The rate of onestage operation in study group and controlled group were 80.1% and 45.8% respectively (P =0.034).The value of OR was 5.02(95% confidence interval was 1.30 to 19.43). The study group has lower bleeding, less time in operation , and faster convalescence, shorter hospital stay, less complication after operation than controlled group.Conclusion: 1.Endoscopic placement of metal stent can loosen the malignant colorectal obstructive sympotoms with lower complication.2. Elective Surgery with stent placement show higher rate of onestage operation, faster convalescence and less complication than Emergency Surgery for malignant colorectal obstruction. It can reduce the patients'trauma and pain,and increase quality of life.