Efficacy of uncovered self-expandable metallic stent for colorectal obstruction by extracolonic malignancy

BACKGROUND Self-expandable metallic stent(SEMS)is widely used for malignant colorectal obstruction.Recently,SEMS has been used for palliative option for colorectal obstruction caused by extracolonic malignancy(ECM).AIM To evaluate the efficacy of SEMS for colorectal obstruction caused by ECM,and to identify the factors associated with stent occlusion.METHODS Seventy-two patients who were treated with uncovered SEMS insertion for malignant colorectal obstructions caused by colorectal metastasis or peritoneal seeding of ECM at Samsung Medical Center between April 2012 to March 2016 were enrolled.We analyzed technical and clinical outcomes of stent insertion,the factors associated with stent occlusion and long term outcomes after stent insertion.RESULTS Technical success rate was determined as 90.3%with a clinical success rate of 87.7%.Stent occlusion developed in 28.1%,with a median duration of 51 d.Further,81.3%with stent occlusion could be treated with secondary stent insertion.Clinical failure was observed to be related to the male sex(P=0.020)and right colon obstruction(P=0.017).Stent length≤10 cm was found to be associated with stent occlusion(P=0.003).Median survival time after stent insertion was 4.7 mo and 40.4%were able to receive their oncological treatments after stent insertion without surgery.CONCLUSION Uncovered SEMS is effective for the treatment of colorectal obstruction caused by ECM,considering life expectancy of patients with ECM.

Fabrication and Drug Release Property of Silk Fibroin-Based Weft-Knitted Stents

This paper was to develop a weft-knitted stent coated by a drug-loaded electro-spun fibrous membrane and then investigate its morphology, mechanical properties and in vitro drug release property. This work was started by weft-knitting of an inner layer of such stent using polydioxanone( PDO) and silkfilament.Subsequently,5-fluorouracil( 5-FU) and curcumin( CUR) ioaded silk fibroin( SF) membranes were coated on the surface of the weftknitted stent using electro-spinning technique to endow the drug delivery function of the stent. The results show that the radial compression strength and circumferential expanding strength can reach above( 9. 1 ± 0. 4) cN/cm^2 and( 205. 0 ± 0. 2) c N/mm,respectively. The drug releasing behaviors can be sustained for 400 h. It is concluded that the stents have potential application as anintestinal stent in the future.