{"title":"Determinants of clinical success and complications in fluoroscopy-guided self-expandable metal stent for treatment of malignant rectal obstruction","authors":"Y. Wan , M.-S. Zou , D. Li , H.-H. Wu , B. Zhang","doi":"10.1016/j.crad.2025.106869","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the safety and efficacy of self-expanding metal stents (SEMS) in the management of patients with malignant rectal obstruction (MRO), as well as to identify the factors contributing to clinical failure and associated complications.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Cases of MRO from September 2014 to July 2024 were retrospectively collected and reviewed. Patient data were analyzed to identify determinants influencing clinical success rates and short-term complications. Subsequently, the log-rank test and Cox proportional hazards model were employed to investigate factors affecting stent patency in palliative treatment.</div></div><div><h3>RESULTS</h3><div>A cohort of 66 MRO patients was included in the analysis. The technical and clinical success rates were observed to be 98.5% and 95.5%, respectively. Multivariate analysis identified the time of obstruction as a significant predictor for clinical success rate (OR = 1.081; 95% CI = 1.081 to 1.148; p=0.010) and the incidence of short-term complications (OR = 1.061; 95% CI = 1.008 to 1.116; p=0.022). In a cohort of 38 patients undergoing palliative treatment, Cox regression analysis identified postoperative chemotherapy as the significant determinant influencing stent patency duration (OR = 0.25; 95% CI = 0.082 to 0.762; p=0.015).</div></div><div><h3>CONCLUSION</h3><div>For MRO patients, SEMS constitutes an efficacious and successful therapeutic approach. Prompt alleviation of the obstruction is associated with a high rate of clinical success and a reduced incidence of short-term complications. Furthermore, in patients undergoing palliative treatment, the administration of postoperative chemotherapy has been shown to extend the duration of stent patency.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106869"},"PeriodicalIF":2.1000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0009926025000741","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Aim
To evaluate the safety and efficacy of self-expanding metal stents (SEMS) in the management of patients with malignant rectal obstruction (MRO), as well as to identify the factors contributing to clinical failure and associated complications.
MATERIALS AND METHODS
Cases of MRO from September 2014 to July 2024 were retrospectively collected and reviewed. Patient data were analyzed to identify determinants influencing clinical success rates and short-term complications. Subsequently, the log-rank test and Cox proportional hazards model were employed to investigate factors affecting stent patency in palliative treatment.
RESULTS
A cohort of 66 MRO patients was included in the analysis. The technical and clinical success rates were observed to be 98.5% and 95.5%, respectively. Multivariate analysis identified the time of obstruction as a significant predictor for clinical success rate (OR = 1.081; 95% CI = 1.081 to 1.148; p=0.010) and the incidence of short-term complications (OR = 1.061; 95% CI = 1.008 to 1.116; p=0.022). In a cohort of 38 patients undergoing palliative treatment, Cox regression analysis identified postoperative chemotherapy as the significant determinant influencing stent patency duration (OR = 0.25; 95% CI = 0.082 to 0.762; p=0.015).
CONCLUSION
For MRO patients, SEMS constitutes an efficacious and successful therapeutic approach. Prompt alleviation of the obstruction is associated with a high rate of clinical success and a reduced incidence of short-term complications. Furthermore, in patients undergoing palliative treatment, the administration of postoperative chemotherapy has been shown to extend the duration of stent patency.
期刊介绍:
Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including:
• Computed tomography
• Magnetic resonance imaging
• Ultrasonography
• Digital radiology
• Interventional radiology
• Radiography
• Nuclear medicine
Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.