Is a small-caliber or large-caliber endoscope more suitable for colonic self-expandable metallic stent placement? A randomized controlled study.

The colonic self-expandable metallic stent (C-SEMS) with a 9-French (Fr) delivery system allows for a small-caliber endoscope (SCE) to be used to treat malignant colonic obstruction. Despite the lack of evidence, the SCE has become popular because it is considered easier to insert than the large-caliber endoscope (LCE). We aimed to determine whether the SCE is more suitable than the LCE for C-SEMS placement. Between July 2018 and November 2019, 50 consecutive patients who were scheduled to undergo C-SEMS for colon obstruction were recruited in this study. Patients were randomized to the SCE or LCE group. The SCE and LCE were used with 9-Fr and 10-Fr delivery systems, respectively. The primary outcome was the total procedure time. Secondary outcomes were the technical success rate, complication rate, clinical success rate, insertion time, guidewire-passage time, stent-deployment time, and colonic obstruction-scoring-system score. Forty-five patients (SCE group, Both LCE and SCE can be used for C-SEMS; however, LCE is more suitable than SCE as it achieved a faster and equally efficacious C-SEMS placement as that of SCE. University Hospital Medical Information Network Clinical Trials Registry (UMIN 32748).

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© The Author(s), 2022.

Déclaration de conflit d'intérêts

Conflict of interest statement: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: EI belongs to an endowed course supported by the companies Ono Pharmaceutical Co., Ltd, Miyarisan Pharmaceutical Co. Ltd, Sanwa Kagaku Kenkyusho Co., Ltd, Otsuka Pharmaceutical Factory, Inc., Fujifilm Medical Co., Ltd, Terumo Corporation, FANCL Corporation, Ohga Pharmacy, and Abbott Japan, LLC. EI receives lecture honorarium from Takeda Pharmaceutical Company. YO conducts collaborative research with Fujifilm Medical Co., Ltd and FANCL Corporation. The authors declare no other conflicts of interest in association with this study.