Concerns on the very high complication rates reported after self-expanding metal stent (SEMS) placement for colorectal cancer in a Catalan retrospective study.

摘要

We read the study of Fernandez-Esparrach et al, (1) with interest. The authors reported a higher than expected complication rate (51%) after SEMS placement in patients with colo-rectal cancer. Several issues need a comment. (a) The migration rate observed in this study (22%) is 11-fold increased compared with those commonly reported (2-5). Chemotherapy could have increased the risk of migration (4). However, the complication rate was not significantly different between treated and untreated patients. Furthermore, in recent series, the chemotherapy-related migration rate seems negligible (2,3,5). Stent migration is strictly dependent on the tightness of the stenosis. In 40% of the reported cases the stenosis could be passed by the scope and in 17% of cases the self-expanding metal stent (SEMS) was placed in asymptomatic patients (1).