Patients who failed endoscopic stenting for left-sided malignant colorectal obstruction suffered the worst outcomes.
Lim T-Z., Chan D., Tan K-K.
BACKGROUND: Reported outcomes of patients followed failed endoscopic stenting for acute left-sided malignant colonic obstruction remained lacking. OBJECTIVES: This study aims to compare the outcomes between endoscopic stenting and emergency surgery in patients with acute left-sided malignant colonic obstruction and to identify factors that predict failed stenting. METHODS: A retrospective review of all patients with acute left-sided malignant colonic obstruction in the National University Hospital, Singapore was performed. RESULTS: From January 2007 to October 2013, 165 patients, with a median age of 68 years (range, 25-96), formed the study group. Sixty-nine (41.8 %) patients underwent immediate surgery. Endoscopic stenting was attempted in 96 (58.2 %) patients and was successful in 76 (79.2 %). The remaining 20 (20.8 %) failed the procedure and were operated immediately. Three of the patients who were successfully stented but did not improve clinically also required emergency surgery. Patients that failed stenting were 13.3 (95 % confidence interval (CI), 3.61-48.8; p