Colonic stenting for colorectal cancer: stoma avoidance with acceptable radiation exposure
File(s)
Published version
Author(s)
Smith, Christopher Robert
Adesida, Michael
Yusuf, Gibran Timothy
Soliman, Hesham
Negametzyanov, Mintimer
Type
Journal Article
Abstract
Background/Aims Self-expanding metal stents (SEMS) are used to manage colonic obstruction for palliative decompression or as a bridge to curative surgery and are typically placed under fluoroscopic guidance. This study aimed to quantify the radiation exposure associated with colonic stenting for obstructing colorectal cancer (CRC) and compare it with established diagnostic reference levels (DRLs) for similar fluoroscopy-guided procedures. Secondary outcomes included procedural success rates, stent patency, stoma rates, and complications.
Methods This retrospective observational study was conducted at a single district general hospital and included all the patients who underwent colonic stenting for CRC between March 2016 and February 2021. Radiation exposure was measured using the kerma-area product (KAP) in µGy*m² and fluoroscopy time in minutes, obtained from existing electronic patient records.
Results Fifty-two stenting procedures were performed in 47 patients. Median KAP was 1,373.7 (interquartile range [IQR], 584.4–3,185.2) µGy*m², and fluoroscopy time was 8.9 (IQR, 4.4–12.6) minutes. Technical and clinical success was achieved in 86.5% of the cases. In palliative cases, 88.9% of patients maintained stent patency until death. The complications included perforation (5.8%) and stent migration (3.9%). Laparoscopic surgery was performed in 70% of curative cases.
Conclusions Radiation exposure during colonic stenting is within acceptable ranges and comparable to that of other fluoroscopy-guided procedures. These findings support the listing of colonic stenting in future National DRLs in the United Kingdom.
Methods This retrospective observational study was conducted at a single district general hospital and included all the patients who underwent colonic stenting for CRC between March 2016 and February 2021. Radiation exposure was measured using the kerma-area product (KAP) in µGy*m² and fluoroscopy time in minutes, obtained from existing electronic patient records.
Results Fifty-two stenting procedures were performed in 47 patients. Median KAP was 1,373.7 (interquartile range [IQR], 584.4–3,185.2) µGy*m², and fluoroscopy time was 8.9 (IQR, 4.4–12.6) minutes. Technical and clinical success was achieved in 86.5% of the cases. In palliative cases, 88.9% of patients maintained stent patency until death. The complications included perforation (5.8%) and stent migration (3.9%). Laparoscopic surgery was performed in 70% of curative cases.
Conclusions Radiation exposure during colonic stenting is within acceptable ranges and comparable to that of other fluoroscopy-guided procedures. These findings support the listing of colonic stenting in future National DRLs in the United Kingdom.
Date Issued
2025-09-01
Date Acceptance
2025-02-02
Citation
Clinical Endoscopy, 2025, 58 (5), pp.738-743
ISSN
2234-2400
Publisher
Korean Society of Gastrointestinal Endoscopy
Start Page
738
End Page
743
Journal / Book Title
Clinical Endoscopy
Volume
58
Issue
5
Copyright Statement
© 2025 Korean Society of Gastrointestinal Endoscopy This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Subjects
Colorectal neoplasms
Fluoroscopy
Gastroenterology & Hepatology
Life Sciences & Biomedicine
Radiation dosage
Science & Technology
Stents
Publication Status
Published
Date Publish Online
2025-07-07