The Effect of Self-Expanding Metallic Stent Insertion for the Treatment of Malignant Colorectal Obstruction

Background/Aims: The aim of this study was to evaluate the clinical and cost effectiveness of the use of stent insertion for malignant colorectal obstruction as compared with performing emergency surgery. Methods: We retrospectively reviewed the medical records of 201 patients. Malignant colorectal obstructions caused by a resectable tumor were treated with preoperative stenting followed by surgery (group A, n=55) or emergency surgery (group B, n=59). Malignant obstructions caused by an unresectable cancer were treated with palliative stenting (group C, n=58) or palliative emergency surgery (group D, n=29). Results: The one-staged radical resection rate was significantly higher in group A patients than in group B patients (87.3% vs. 52.5%, p＜0.05). Post-operative complications were more frequent in group A patients than in group B patients (9.1% vs. 32.2%, p＜0.05). The admission period was significantly shorter for group A patients than for group B patients (25.0 days vs. 33.7 days, p＜0.05). The medical cost was not different for group A and group B patients. Life-long stoma formation was necessary for 15.5% of group C patients and 69% of group D patients, respectively. The admission period was significantly shorter for group C patients than group D patients (10.5 days vs. 22.7 days, p＜0.05). The medical cost was not different for group C and D patients. Conclusions: Stent insertion was an effective treatment modality for malignant colorectal obstruction. (Korean J Gastrointest Endosc 2008;36:274-281)