OUTCOMES OF A TERTIARY CENTRE'S REAL WORLD EXPERIENCE WITH COLONIC SELF EXPANDING METAL STENTS (SEMS)

Introduction Olonic self-expanding metal stents (SEMS) are recommended in the management of malignant strictures, with obstruction. ublished studies have low caseloads and may not reflect real world practice. Methods All cases coded with endoscopic or image guided insertion of stent or tubal prosthesis (codes H214, H243, H244, H273, H274, H314) were reviewed to identify colonic SEMS cases. Electronic notes, endoscopy and radiology reports were reviewed. Data on, site of SEMS, indication, insertion method immediate late complications30-daymortality were noted. Results Episodes were coded of which 101 colonic stent insertions. SEMS insertions included local and tertiary referrals, either planned or in an emergency setting. Of the 101 cases, 58.4% of patients were male (n=59), with a median age of 75 years (range 28–95 years). The majority of SEMS (91.1%, n=92) were inserted endoscopically with fluoroscopy, with the remaining nine cases being inserted radiologically, by multiple operators. Indications for insertion included palliative (n=72) or curative (n=21) malignancy (defined by treatment intention on MDT outcome), with 4 cases being for benign disease. Most patients (79.2%) requiring SEMS had obstructive symptoms. complications included cases of perforation (%)of unknown cause. One case had an 8 day unplanned readmission. cases of stent migration (%) cases of stent occlusion secondary to tumour in-growth (%) cases (3.96%) of delayed perforation (which were felt to be tumour related). All cause 30 day mortality rate was 14.9% (n=15), with only 7 cases (6.93%) relating to stent failure or complication. Conclusions This large real-world data review highlights complication rates of SEMS in a heterogeneous population with multiple operators over 7 years of both emergency and planned procedures for malignant colonic strictures. Colonic SEMS is aand relatively safe therapeutic option for thepalliative management of colonic malignancy with obstruction