Radiation Exposure with Self-Expandable Metallic Stent Versus Transanal Decompression Tube for Malignant Colorectal Obstruction: A Post Hoc Propensity Score Matched Analysis

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Oct 16

PMID 39407984

Authors

Yuzuru Tamaru

Toshio Kuwai

Shiro Hayashi

Koji Nagaike

Takayuki Yakushijin

Satoshi Asai

Masashi Yamamoto

Shinjiro Yamaguchi

Takuya Yamada

Kenkei Hasatani

Hideyuki Ihara

Hidetaka Tsumura

Hisashi Doyama

Iruru Maetani

Toshio Fujisawa

Yukiko Ito

Tadayuki Takagi

Yasuki Hori

Mamoru Takenaka

Makoto Hosono

Tsutomu Nishida

Affiliations

Soon will be listed here.

Abstract

Although several reports have compared the outcomes of self-expandable metallic stent (SEMSs) and transanal decompression tube (TDT) placement for malignant colorectal obstruction (MCO), few studies have compared the radiation exposure (RE) associated with these two procedures. Consequently, we aimed to compare the RE of SEMS and TDT placements for MCO using propensity score matching (PSM) in a multi-center, prospective observational study. This study investigated the clinical data of 236 patients who underwent SEMS or TDT placement. The air kerma at the patient entrance reference point (K: mGy) and air kerma-area product (P; Gycm) were measured and compared between SEMS and TDT groups after PSM. After PSM, 61 patients were identified in each group. The median K in the SEMS group was significantly greater than that in the TDT group (77.4 vs. 55.6 mGy; = 0.025) across the entire cohort. With respect to subgroup analyses by location, in the rectum, the median K and P were significantly greater in the SEMS group than in the TDT group (172.9 vs. 34.6 mGy; = 0.001; and 46.0 vs. 18.1 Gycm; = 0.006, respectively). However, in the colon, the RE parameters did not significantly differ between the two groups. TDT might be a more suitable option for decompression in patients with malignant rectal obstruction due to its lower RE and technical advantages. Conversely, SEMS placement is recommended as the first decompression method to treat malignant colonic obstruction, in line with the current guidelines.

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