대한소화기학회로고
 
 
 
Author Ji Won Kim, Ji Bong Jeong, Kook Lae Lee, Byeong Gwan Kim, Yong Jin Jung, Won Kim, Hwi Young Kim, Dong Won Ahn, Seong-Joon Koh and Jae Kyung Lee
Place of duty Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea
Title Comparison of Clinical Outcomes between Endoscopic and Radiologic Placement of Self-expandable Metal Stent in Patients with Malignant Colorectal Obstruction
Publicationinfo The Korean Journal of Gastroenterology 2013 Jan; 061(01): 22-29.
Key_word Colorectal neoplasm; Stent; Endoscope; Interventional radiology
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Abstract Background/Aims: This study compared the clinical outcomes between endoscopic and radiologic placement of self-expandable metal stent (SEMS) in patients with malignant colorectal obstruction.Methods: In total, 111 patients were retrospectively enrolled in this study between January 2003 and June 2011 at Seoul National University Boramae Hospital. Technical and clinical success rates, complication rates, and stent patency were compared between using an endoscopic (n=73) or radiologic (n=38) method during the SEMS placement procedure.Results: The technical success rate was higher in the endoscopic method than in the radiologic method (100% [73/73] vs. 92.1% [35/38], respectively; p=0.038). In addition, in 3 of the remaining 35 patients in the radiologic-method group, adjuvant endoscopic assistance was required. In the six patients (including the three aforementioned patients), the causes of technical failure were the inability to pass the guidewire into an obstructive lesion due to a tortuous, curved angulation of the sigmoid or descending colon (n=4), and a difficult approach to a lesion located at the descending or transverse colon (n=2). The clinical success rate, complication rate, and stent patency did not differ significantly between the two methods (p=0.424, 0.303, and 0.423, respectively).Conclusions: When the colorectal obstruction had a tortuous, curved angulation of the colon or was located at or proximal to the descending colon, the endoscopic method of SEMS placement appears to be more useful than the radiologic method. However, once SEMS placement was technically successful, the clinical success rate, complication rate, and stent patency did not differ with the method of insertion. (Korean J Gastroenterol 2013;61:22-29)
저 자 김지원, 정지봉, 이국래, 김병관, 정용진, 김 원, 김휘영, 안동원, 고성준, 이재경
소 속 서울대학교 의과대학 보라매병원 내과학교실
제 목 악성 대장 폐쇄 환자에서 자가팽창성 금속 스텐트의 임상적 효과: 내시경적 및 방사선적 삽입법 비교
출판정보 Korean J Gastroenterol 2013 Jan; 061(01): 22-29.
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