Comparison of self-expandable metallic stent placement for acute colorectal obstruction caused by extracolonic malignancy and colorectal cancer        ZHOU Jia-min, ZHONG Yun-shi, XU Mei-dong, et al. Endoscopy Center, Zhongshan Hospital, Fudan University; Endoscopy Clinics Institute of Fudan University; Technology Engineering Research Center of Shanghai Endoscopy Clinics, Shanghai200032, China
Corresponding author：YAO Li-qing, ZHONG Yun-shi, E-mail：13564623481@126.com
Abstract    Objective    To evaluate the safety，efficacy and prognosis of self-expendable metallic stent (SEMS）placement in patients with acute colorectal obstruction (ACO) caused by extracolonic malignancies (ECM). Methods   One hundred and nine cases of ACO admitted between November 2006 and April 2012 in Zhongshan Hospital of Fudan University were analyzed. The cases caused by metastatic or recurrent colorectal cancer (CRC) (n = 96) were compared with the cases caused by ECM (n = 13) in success rate，complications and survival time. Results    ECM group included 8 cases of gastric cancer（61.5%），3 cases of gynecologic cancer（23.1%），1 case of bladder cancer （7.7%）and 1 case of pelvic inflammatory fibroblastic tumor （7.7%）. The technical success rate was 100% in both ECM group and CRC group. The clinical remission rate was not significantly different between the two groups (77.0% vs. 83.3%，P = 0.696). The stent patency time was also similar between the two groups (117.0 ± 148.8 vs. 188.2 ± 203.6，P =0.230). Stent related complications in ECM group included 2 cases of reobstruction and 1 case of migration. Symptom was not relieved in 1 case performed SEMS placement. There were not significantly difference in 30-day mortality，1-year survival rate and overall survival rate between two groups (P= 1.000，P= 0.140，P= 0.282). Conclusion    The safety and effectiveness of SEMS placement in patients with ACO caused by ECM are comparable to that in patients with ACO caused by metastatic or recurrent CRC. It may be an appropriate option for treating malignant ACO.