Colonic stenting in colorectal malignancy-a single centre 3 year review

Aim/Background: Colonic stent insertion is a minimally invasive management option for patients requiring colonic decompression in colorectal malignancy (CRC). Acute colonic obstruction is a common presentation in patients with CRC, and approximately 20% present with distant metastases. Emergency primary resection carries increased morbidity and mortality and decreases likelihood of primary anastomosis. Our objective was to review the use of colorectal stents, examine survival in the palliative setting and determine interval time to surgery. Methods: A retrospective institutional review of all patients undergoing colonic stenting in a single centre between January 2018 and January 2021 was carried out. Data was retrieved from an institutional database search and patient follow up obtained from up to date regional care records. Results: A total of 58 patients were identified, 50 of which underwent attempted stenting for a colonic malignancy, with a 92% success rate. Median age 81.5years (54-95), 60.8% male and median follow up time 545 ± 353 days. Thirty three (64.8%) were performed in the emergency setting. Thirteen patients underwent stenting as a bridge to surgery, with median time interval 20 days (2018/2019) and 30.5 days (2020/2021). Thirty-three patients underwent stenting with palliative intent, with a median survival time of 96 days. There were no major stent related complications or mortality. Conclusion: Colonic stents offer an alternative management pathway in obstructed colorectal malignancies, in both the palliative and curative setting. Our study has illustrated high success rates, with no major complications seen. COVID-19 has expectedly impacted the length of time to surgery following stent insertion.