Objective To prospectively evaluate the safety and clinical efficacy of a newly designed self-expandable metallic stent ( SEMS ) placement in the treatment of patients with acute malignant colorectal obstruction due to colorectal carcinomas. Methods During the period from April 2001 to October 2007 , a total of 52 patients with acute malignant colorectal obstruction were treated with stent placement by using a new designed SEMS, which was employed as a preoperative transit means. All the patients were followed up and the relevant data, including technical success rate, clinical efficacy, complications and overall survival rate, were documented. The results were analyzed. Results Stent placement was successfully carried out in all patients except for two patients who showed complete colorectal obstruction. No procedure-related complications occurred. Technical success rate was 96％ ( 50/52 ). Two days after the treatment,, the relief rate of colorectal obstruction was 98％ ( 49/50 ). Postoperative complications included stent migration ( n =4 ), anal pain ( n = 2 ) and stool impaction ( n = 1 ). The stool impaction seen in one patient was successfully removed away with endoscopic manipulation two days after stent placement. An elective one-stage surgical procedure was performed in all 50 patients who successfully received a SEMS placement within a mean interval of ( 8 ± 2 ) days ( ranged 4 - 11 days ) after stent placement. Mean follow-up time was ( 36 ± 12 ) months with a range of ( 3 - 70 ) months. All patients remained alive at the time of this report. Conclusion The newly designed SEMS placement used as a preoperative transit means is a safe and effective intervention for colonic decompression in patients with acute malignant colorectal obstruction due to colorectal carcinomas.It can reliably ensure most of patients with colorectal carcinomas to successfully accomplish an elective surgery. ( J Intervent Radiol, 2011, 20 : 799-802 )%目的 探讨自膨胀金属支架(SEMS)置入对结直肠癌患者所致急性结肠梗阻择期手术的作用.方法 2001年4月-2010年12月,对急性结肠梗阻、拟择期手术的52例结直肠癌患者使用自膨胀金属支架治疗.收集患者的相关数据,包括技术和临床疗效、并发症、择期外科手术成功率及生存时间.结果 52例中除2例完全梗阻外,其余支架置入均获得技术成功,且无手术相关并发症,技术成功率为96%(50/52).支架植入后2 d内,技术成功的50例患者中49例患者肠梗阻解除.不良反应有4例支架移位,2例肛门疼痛,1例粪便堆积,通过肠镜疏通得以解决.50例患者在自膨胀金属支架置入后的(8 ± 2)d(4～11 d)内择期行肿瘤根治术.随访(36 ± 12)个月(3～70个月),所有患者均存活.结论 新型自膨胀金属支架对治疗结直肠癌所致急性结肠梗阻择期手术患者安全、有效,同时能确保大多数患者择期外科根治手术的成功实施.
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