Introduction: Colonic endoluminal stent placement is a commonly utilized and effective endoscopic approach for the management of malignant large bowel obstruction and is an emerging approach for the management of some benign etiologies of large bowel obstruction. However, recent studies evaluating the evolution of clinical scenarios and patient populations for which stenting is performed in real-world practice are lacking. Methods: We assessed colonic stent utilization patterns in a tertiary care academic medical center over the past 10 years. We analyzed the demographics and patient and procedure characteristics of the initial (first half of study period) and latter (second half of the study period) procedures to assess trends over time using standard descriptive statistics. Results: Our analysis was notable due to its provision of some novel insights. The frequency of colonic stent placement procedures increased significantly over time by comparison of the procedure volume for the initial 5-year interval (22 colonic stent procedures) relative to the latter 5-year interval (49 colonic stent procedures) (p= 0.03). The median age of patients who underwent colonic stent placement was significantly lower in the latter 5 years, compared with the initial 5 years of the study period (mean of 81.41 vs. 58.73 years, respectively,p< 0.001). The increased diversity of indications for colonic stent placement was also noted over time. Conclusions: Our data highlight the evolution of colonic stent placement in tertiary care practice over time and are notable for some interesting trends, including the increased utilization of colonic stent placement over time, the broadening of indications for colonic stent placement to include benign indications, and lower patient age at the time of colonic stent placement over time. These findings will help inform the clinical practice of colonic stent placement and provide a foundation to guide future research on the topic.
引言：结肠腔内支架置入术是处理恶性大肠梗阻常用且有效的内镜方法，也是处理某些良性大肠梗阻病因的新兴手段。然而，目前缺乏评估真实世界临床实践中支架置入术应用场景和患者群体演变的研究。方法：我们评估了一家三级医疗学术医学中心过去10年结肠支架的使用模式。通过标准描述性统计方法，我们分析了研究前期（研究时段前半期）与后期（研究时段后半期）手术的患者人口统计学特征及手术特点，以评估随时间变化的趋势。结果：本分析因提供若干新颖见解而值得关注。通过比较前5年（22例结肠支架手术）与后5年（49例结肠支架手术）的手术量，发现结肠支架置入术的实施频率随时间显著增加（p=0.03）。研究后期接受结肠支架置入术的患者中位年龄显著低于研究前期（均值分别为58.73岁 vs 81.41岁，p<0.001）。同时观察到结肠支架置入术的适应症范围随时间推移呈现多样化趋势。结论：我们的数据揭示了三级医疗实践中结肠支架置入术的演变过程，其中若干趋势值得关注：结肠支架置入术使用率随时间增长；适应症范围扩展至包含良性病症；患者置入支架时的年龄呈现年轻化趋势。这些发现将为结肠支架置入术的临床实践提供参考，并为该领域的未来研究奠定基础。
Tertiary Care Center Trends in Colonic Stent Placement over the Past Decade
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