Covered versus uncovered endoluminal stenting in the acute management of obstructing colorectal cancer in the palliative setting: randomized clinical trial (CReST2) - Summary - MDSpire

Covered versus uncovered endoluminal stenting in the acute management of obstructing colorectal cancer in the palliative setting: randomized clinical trial (CReST2)

  • By

  • CReST2 Collaborative Group

  • James Hill

  • Nicola Fearnhead

  • Richard Gray

  • Kelly Handley

  • Manjinder Kaur

  • Clive Kay

  • Hans-Ulrich Laasch

  • Andrew Lowe

  • Laura Magill

  • Dion Morton

  • Ruben Mujica-Mota

  • Andy Palmer

  • Anne Pullyblank

  • Yongzhong Sun

  • Suresh Vasan Venkatachalapathy

  • Pete Wheatstone

  • Yasmin Ali

  • Altus Chan

  • Suzanne Locker

  • Paul Riley

  • Gordon Carlson

  • Stuart Taylor

  • Sarah Barry

  • Philip Bell

  • Steve Halligan

  • Nigel Scott

  • Suhail Ahmed

  • James Arthur

  • Carol Brooks

  • Jane L Hughes

  • Tanya Ingram

  • Michelle Linforth

  • Sophie Marsh

  • Rizwan Saleem

  • Simone Slawik

  • Sarah Stevenson

  • Lilian Wajero

  • Nicholas Cross

  • Amanda Dell

  • Mandy Edwards

  • Angela Hall

  • Helen Hamilton

  • Nancy Hawkins

  • Heidi Lawson

  • Mark Robinson

  • Michelle Tayler

  • Rebecca Wallace

  • Sarah Wheatman

  • Joanna Wilson

  • Lindianne Aitken

  • Rhodri Codd

  • Joseph Hamill

  • Nancy Hawkins

  • Georgia Mallison

  • Steve McKain

  • Heeam Nassa

  • Claire Louise Price

  • Mark Robinson

  • Brian Stephenson

  • Keshav Swarnkar

  • Claire Triscott

  • Elaine Wall

  • Rebecca Wallace

  • Gethin Williams

  • Cerian Williams

  • Rommel Butawan

  • Joseph Huang

  • Sam King

  • Tina Mills-Baldock

  • Purushothaman Premchand

  • Alison Ray

  • Amy Barnett

  • Alexander Blackmore

  • Oliver Brennan

  • Melaine Caswell

  • Greta Van Doyvenvoorde

  • James Glen

  • Shamina Hankinson

  • Mark Hendrickse

  • Peter Isaacs

  • Ilianna Mamali

  • Senthil Murugesan

  • Marina Oprea

  • Chris Pemberton

  • Ella Riedel

  • Arunan Sivapataham

  • Wei Fen Tay

  • Lauren Thornborough

  • Rachel Wheeldon

  • Conor Wilkinson

  • Julie Chadwick

  • Shirley Cocks

  • Gemma Faulkner

  • Robert Hull

  • Marta Martinez Iglesias

  • James Lay

  • Ha Phuong Do Le

  • James Pollard

  • Shenraga Kumar Rajamanickam

  • Rubeena Razzaq

  • Michaela Sutherland

  • Aphan Abdulholim

  • Conrad Beckett

  • Wendy Cardozo

  • Carol Firth

  • Naeem Jagirdar

  • Wendy Jepson

  • Sarah Jowett

  • Amjad Mohammed

  • Sulleman Moreea

  • Nicolas Rabb

  • Jonathan Robinson

  • Sophie Stephenson

  • Sarah Tinker

  • Ashlea Bucke

  • Ewen Cameron

  • Nicholas Carroll

  • Gareth Corbett

  • Nicola Fearnhead

  • Nigel Hall

  • Alisa Liddle

  • Ines Modolell

  • Jonathan Morton

  • Aileen Nacorda

  • Sophie Newton

  • Beverley Nobbs

  • Debbie Read

  • Rebekka Troller

  • James Wheeler

  • Lucy Worboys

  • Megan Brickhill

  • Chris Craig

  • Finlay Curran

  • David Donnelly

  • Mona Fareh

  • Bethanie Garside

  • Glaxy Gray

  • Richard Hammonds

  • Babra Hanif

  • James Hill

  • Benjamin Hornung

  • Anu John

  • Maya John

  • Stephen Lee

  • Jesha Mathews

  • Pavenjit Nandhra

  • Mohammed Nazir

  • Jessica Nichols

  • Sarah O'Shea

  • Alice Panes

  • Laura Perry

  • Angelique Quistin

  • Rojy Santosh

  • Nicholas Stylianides

  • Jennifer Trezise

  • Denielle Wilcock

  • Gian Abbott

  • Paul Evans

  • Claire Gabriel

  • Jenny Grounds

  • Nichola Kearsley

  • Roy Mahapatra

  • Collette Markzu

  • Emmeline Martin

  • Laura Parry

  • Sandra Powell

  • Kunal Rajput

  • Dale Vimalachandran

  • Andrea Young

  • Helen Boros

  • Lisa Hardstaff

  • Philippa Hill

  • Maureen Holland

  • Debra Jowle

  • Konrad Koss

  • Barbara Townley

  • Lesley Wilknson

  • Hayley Cousins

  • Barbara King

  • John Ramage

  • Amanda Alty

  • Paul Barrow

  • Alan Beveridge

  • Arnab Bhowmick

  • Alistair Craig

  • Terri-Louise Cromie

  • Tarek Hany

  • Alka Jadav

  • Janet Mills

  • Peter Mitchell

  • Ed Parkin

  • Ioannis Peristerakis

  • Sandra Sowden

  • Robert Stockwell

  • Gagandeep Thind

  • Louis Turrel

  • Mark Verlander

  • Ailsa Watt

  • Deborah Weavers

  • Alexandra Williams

  • Miranda Baum

  • Simon Everett

  • Vinod Hegade

  • Matthew Huggett

  • Susan Kelly

  • Rebecca King

  • Lucy Marshall

  • Catherine Moriarty

  • Bharat Paranandi

  • Mark Priestley

  • Rick Saunders

  • Holly Speight

  • Louise White

  • Haidar Alwan-Walker

  • Helen Ashby

  • Linda Bailey

  • Wal Baraza

  • Molly Bennett

  • Angela Chrisopoulou

  • Sarah Duff

  • Laura Hancock

  • Zoe Holliday

  • Javaid Iqbal

  • Venkata Lekharaju

  • Fiona McCartin

  • Gorei Mccavil

  • Stephen Metcalfe

  • Heena Mistry

  • Lindsay Piper

  • Aswatha Ramesh

  • Velauthan Rudralingam

  • Abhiram Sharma

  • Kathryn Slevin

  • Karen Telford

  • Debbie West

  • Kate Whitehead

  • Peter Coyne

  • James Graham

  • Stephanie Grieveson

  • Ben Griffiths

  • Lorna Ingoe

  • Sam McDonald

  • Victoria Murtha

  • Adam Scadeng

  • Julia Scott

  • Elaine Stephenson

  • Vithusa Varnakillasingam

  • Nelson Wong

  • Avril Donaldson

  • Kathleen Macleod

  • Andrew Macleod

  • Joanna Matheson

  • Raymond Oliphant

  • Alastair Todd

  • Michael Walker

  • Angus Watson

  • Angie Balfour

  • Domenyk Brown

  • John Brush

  • Stephen Glancy

  • Sarah Goodbrand

  • Marion MacRury

  • Chinnappa Reddy

  • Doug Speake

  • Geoff Wogan

  • Sarah Bevins

  • Kirstie Bradburn

  • Caroline Burt

  • Neil Collin

  • Graham Collin

  • Laura Fox

  • Robert Healey

  • Mitchell Hopes

  • Shinu Jackson

  • Alice Jarvie

  • Regina Kageni

  • Suriya Kirkpatrick

  • Sam Loud

  • Eric Loveday

  • Ann Lyons

  • Kathryn McCarthy

  • Tom McGirr

  • Angus McNair

  • Peter Mezes

  • Emily Perry

  • Anne Pullyblank

  • Sosamma Robin

  • Maricruz Santamaria

  • Alice Smith

  • Andrew Smith

  • Louise Solomon

  • Haytham Sumrien

  • Isileli Tonga

  • Katherine Way

  • David Westwood

  • Guruprasad P Aithal

  • Andrew Baxter

  • Suzanne Henry

  • Martin James

  • Amardeep Khanna

  • Jodie Newham

  • Sian Kelly Parkes

  • Stephen Ryder

  • Ioannis Varmpompitis

  • Suresh Vasan Venkatachalapathy

  • Samantha Warburton

  • Sarah Askew

  • Kerry Atkinson

  • Madalina Chifu

  • Candy Coombe

  • Sophia Eloi

  • Clare Ferris

  • Elizabeth Firth

  • Caroline Goddard

  • Anne Griffiths

  • John Hancock

  • Angela Irving

  • Kirsty Maclean

  • John Madine

  • Corrine Penhaligon

  • Catherine Pentescost

  • Kirsty Prout

  • Rebecca Rogers

  • Rebecca Sargent

  • Anita Steele

  • Felicity Verma

  • Michael Agyemang

  • Sarah Bird

  • Steven Brown

  • Holly Caborn

  • Joyce Fofie

  • James Hampton

  • Faith Kibutu

  • Fred Lee

  • Cecilia Mason

  • Angeline Mbuyisa

  • Helen Newell

  • Viktoria Cripps

  • Thomas Edwards

  • Nicky Forsyth

  • Louise Hunt

  • Andrew Lowe

  • Paul Mackey

  • Rudi Matull

  • Alison Moss

  • Corinne Pawley

  • Tamlyn Russell

  • Maria Salter

  • Charmaine Shovelton

  • Edward Smyth

  • Angela Berry

  • Nicola Broome

  • Grant Caddy

  • John Eccles

  • Jennifer Foreman

  • Tony Tham

  • Alex Usher-Rea

  • Andrew Wray

  • Gail Young

  • Harry Bond

  • Theresa Taylor Emberton

  • Hans-Ulrich Laasch

  • Sue Lane

  • Damian Mullan

  • Lyne Robertson

  • Maria RoyoGamara

  • Marie Green

  • Brian McKaig

  • Shyam Menon

  • Rajinder Nayyar

  • Julie Roberts

  • Helen Steed

  • Andrew Veitch

  • Sarah Addison

  • Shazad Ashraf

  • Simon Bach

  • Anil Bagul

  • Elizabeth Bailey

  • Andrew Beggs

  • Colm Forde

  • Sharon Garner

  • Manijeh Ghods

  • Andrew McDarby

  • Claire McNeill

  • Dion Morton

  • Dimitri Nepogodiev

  • Arvind Pallan

  • Tom Pinkney

  • Jonathan Richardson

  • Nigel Suggett

  • Sharan Wadhwani

  • Stephan Ward

  • Arlo Whithouse

  • Deborah Wright

  • Hasan Al Chalabi

  • Ashish Bhalla

  • Jo Chmiel

  • Julie Edmonds

  • Jodie Fitzgerald

  • Nicole Isitt

  • Jonathan Lund

  • Nicole Mckee

  • Joely Morgan

  • Elizabeth Nadin

  • Ellie Piggott

  • Rajeev Singh

  • Katherine Smith

  • William Speake

  • Peter Thurley

  • Samson Tou

  • Christ Worth

  • Jill Cooke

  • Rachel Plummer

  • Baljit Singh

  • Ratan Verma

  • Ndkeita Barnett

  • Adrian Butler

  • Susan Gallagher

  • Amanda Hall

  • Kar Wai Lau

  • Mia Marsden

  • Michael Martin

  • Katrina Parkinson

  • Rochelle Rhodes

  • Alison Tilley

  • Janine Mallinson

  • Tania Neale

  • Ian Renwick

  • Jacqui Smith

  • Alison Turnbull

  • September 17, 2025

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Objective:

To determine the efficacy of covered versus uncovered stents in terms of stent patency, complications, and quality of life in patients with bowel obstruction due to colorectal cancer in a palliative setting, emphasizing the comparative aspect.

Key Findings:
  • Stenting was unsuccessful in 12.5% of patients.
  • Stent patency at 6 months was 72.7% for covered stents and 81.9% for uncovered stents.
  • Quality of life scores were similar between groups, with mean scores of 54.1 for covered and 51.6 for uncovered stents.
  • Complication rates were higher for covered stents (26.1%) compared to uncovered stents (17.5%), with stent migration being the most common complication.
Interpretation:

Uncovered stents demonstrated greater prolonged patency and fewer complications compared to covered stents, while quality of life remained unaffected by stent design, suggesting a preference for uncovered stents in clinical practice.

Limitations:
  • The study excluded patients with certain conditions, which may limit generalizability and introduce selection bias.
  • The trial was conducted in a specific healthcare setting, which may not reflect broader populations, potentially affecting the applicability of the results.
Conclusion:

Uncovered stents may be preferable for managing obstructing colorectal cancer in palliative care due to better stent patency and lower complication rates, highlighting the need for careful consideration in clinical decision-making.

Original Source(s)

Covered versus uncovered endoluminal stenting in the acute management of obstructing colorectal cancer in the palliative setting: randomized clinical trial (CReST2)

  • by CReST2 Collaborative Group, James Hill, Nicola Fearnhead, Richard Gray, Kelly Handley, Manjinder Kaur, Clive Kay, Hans-Ulrich Laasch, Andrew Lowe, Laura Magill, Dion Morton, Ruben Mujica-Mota, Andy Palmer, Anne Pullyblank, Yongzhong Sun, Suresh Vasan Venkatachalapathy, Pete Wheatstone, Yasmin Ali, Altus Chan, Suzanne Locker, Paul Riley, Gordon Carlson, Stuart Taylor, Sarah Barry, Philip Bell, Steve Halligan, Nigel Scott, Suhail Ahmed, James Arthur, Carol Brooks, Jane L Hughes, Tanya Ingram, Michelle Linforth, Sophie Marsh, Rizwan Saleem, Simone Slawik, Sarah Stevenson, Lilian Wajero, Nicholas Cross, Amanda Dell, Mandy Edwards, Angela Hall, Helen Hamilton, Nancy Hawkins, Heidi Lawson, Mark Robinson, Michelle Tayler, Rebecca Wallace, Sarah Wheatman, Joanna Wilson, Lindianne Aitken, Rhodri Codd, Joseph Hamill, Nancy Hawkins, Georgia Mallison, Steve McKain, Heeam Nassa, Claire Louise Price, Mark Robinson, Brian Stephenson, Keshav Swarnkar, Claire Triscott, Elaine Wall, Rebecca Wallace, Gethin Williams, Cerian Williams, Rommel Butawan, Joseph Huang, Sam King, Tina Mills-Baldock, Purushothaman Premchand, Alison Ray, Amy Barnett, Alexander Blackmore, Oliver Brennan, Melaine Caswell, Greta Van Doyvenvoorde, James Glen, Shamina Hankinson, Mark Hendrickse, Peter Isaacs, Ilianna Mamali, Senthil Murugesan, Marina Oprea, Chris Pemberton, Ella Riedel, Arunan Sivapataham, Wei Fen Tay, Lauren Thornborough, Rachel Wheeldon, Conor Wilkinson, Julie Chadwick, Shirley Cocks, Gemma Faulkner, Robert Hull, Marta Martinez Iglesias, James Lay, Ha Phuong Do Le, James Pollard, Shenraga Kumar Rajamanickam, Rubeena Razzaq, Michaela Sutherland, Aphan Abdulholim, Conrad Beckett, Wendy Cardozo, Carol Firth, Naeem Jagirdar, Wendy Jepson, Sarah Jowett, Amjad Mohammed, Sulleman Moreea, Nicolas Rabb, Jonathan Robinson, Sophie Stephenson, Sarah Tinker, Ashlea Bucke, Ewen Cameron, Nicholas Carroll, Gareth Corbett, Nicola Fearnhead, Nigel Hall, Alisa Liddle, Ines Modolell, Jonathan Morton, Aileen Nacorda, Sophie Newton, Beverley Nobbs, Debbie Read, Rebekka Troller, James Wheeler, Lucy Worboys, Megan Brickhill, Chris Craig, Finlay Curran, David Donnelly, Mona Fareh, Bethanie Garside, Glaxy Gray, Richard Hammonds, Babra Hanif, James Hill, Benjamin Hornung, Anu John, Maya John, Stephen Lee, Jesha Mathews, Pavenjit Nandhra, Mohammed Nazir, Jessica Nichols, Sarah O'Shea, Alice Panes, Laura Perry, Angelique Quistin, Rojy Santosh, Nicholas Stylianides, Jennifer Trezise, Denielle Wilcock, Gian Abbott, Paul Evans, Claire Gabriel, Jenny Grounds, Nichola Kearsley, Roy Mahapatra, Collette Markzu, Emmeline Martin, Laura Parry, Sandra Powell, Kunal Rajput, Dale Vimalachandran, Andrea Young, Helen Boros, Lisa Hardstaff, Philippa Hill, Maureen Holland, Debra Jowle, Konrad Koss, Barbara Townley, Lesley Wilknson, Hayley Cousins, Barbara King, John Ramage, Amanda Alty, Paul Barrow, Alan Beveridge, Arnab Bhowmick, Alistair Craig, Terri-Louise Cromie, Tarek Hany, Alka Jadav, Janet Mills, Peter Mitchell, Ed Parkin, Ioannis Peristerakis, Sandra Sowden, Robert Stockwell, Gagandeep Thind, Louis Turrel, Mark Verlander, Ailsa Watt, Deborah Weavers, Alexandra Williams, Miranda Baum, Simon Everett, Vinod Hegade, Matthew Huggett, Susan Kelly, Rebecca King, Lucy Marshall, Catherine Moriarty, Bharat Paranandi, Mark Priestley, Rick Saunders, Holly Speight, Louise White, Haidar Alwan-Walker, Helen Ashby, Linda Bailey, Wal Baraza, Molly Bennett, Angela Chrisopoulou, Sarah Duff, Laura Hancock, Zoe Holliday, Javaid Iqbal, Venkata Lekharaju, Fiona McCartin, Gorei Mccavil, Stephen Metcalfe, Heena Mistry, Lindsay Piper, Aswatha Ramesh, Velauthan Rudralingam, Abhiram Sharma, Kathryn Slevin, Karen Telford, Debbie West, Kate Whitehead, Peter Coyne, James Graham, Stephanie Grieveson, Ben Griffiths, Lorna Ingoe, Sam McDonald, Victoria Murtha, Adam Scadeng, Julia Scott, Elaine Stephenson, Vithusa Varnakillasingam, Nelson Wong, Avril Donaldson, Kathleen Macleod, Andrew Macleod, Joanna Matheson, Raymond Oliphant, Alastair Todd, Michael Walker, Angus Watson, Angie Balfour, Domenyk Brown, John Brush, Stephen Glancy, Sarah Goodbrand, Marion MacRury, Chinnappa Reddy, Doug Speake, Geoff Wogan, Sarah Bevins, Kirstie Bradburn, Caroline Burt, Neil Collin, Graham Collin, Laura Fox, Robert Healey, Mitchell Hopes, Shinu Jackson, Alice Jarvie, Regina Kageni, Suriya Kirkpatrick, Sam Loud, Eric Loveday, Ann Lyons, Kathryn McCarthy, Tom McGirr, Angus McNair, Peter Mezes, Emily Perry, Anne Pullyblank, Sosamma Robin, Maricruz Santamaria, Alice Smith, Andrew Smith, Louise Solomon, Haytham Sumrien, Isileli Tonga, Katherine Way, David Westwood, Guruprasad P Aithal, Andrew Baxter, Suzanne Henry, Martin James, Amardeep Khanna, Jodie Newham, Sian Kelly Parkes, Stephen Ryder, Ioannis Varmpompitis, Suresh Vasan Venkatachalapathy, Samantha Warburton, Sarah Askew, Kerry Atkinson, Madalina Chifu, Candy Coombe, Sophia Eloi, Clare Ferris, Elizabeth Firth, Caroline Goddard, Anne Griffiths, John Hancock, Angela Irving, Kirsty Maclean, John Madine, Corrine Penhaligon, Catherine Pentescost, Kirsty Prout, Rebecca Rogers, Rebecca Sargent, Anita Steele, Felicity Verma, Michael Agyemang, Sarah Bird, Steven Brown, Holly Caborn, Joyce Fofie, James Hampton, Faith Kibutu, Fred Lee, Cecilia Mason, Angeline Mbuyisa, Helen Newell, Viktoria Cripps, Thomas Edwards, Nicky Forsyth, Louise Hunt, Andrew Lowe, Paul Mackey, Rudi Matull, Alison Moss, Corinne Pawley, Tamlyn Russell, Maria Salter, Charmaine Shovelton, Edward Smyth, Angela Berry, Nicola Broome, Grant Caddy, John Eccles, Jennifer Foreman, Tony Tham, Alex Usher-Rea, Andrew Wray, Gail Young, Harry Bond, Theresa Taylor Emberton, Hans-Ulrich Laasch, Sue Lane, Damian Mullan, Lyne Robertson, Maria RoyoGamara, Marie Green, Brian McKaig, Shyam Menon, Rajinder Nayyar, Julie Roberts, Helen Steed, Andrew Veitch, Sarah Addison, Shazad Ashraf, Simon Bach, Anil Bagul, Elizabeth Bailey, Andrew Beggs, Colm Forde, Sharon Garner, Manijeh Ghods, Andrew McDarby, Claire McNeill, Dion Morton, Dimitri Nepogodiev, Arvind Pallan, Tom Pinkney, Jonathan Richardson, Nigel Suggett, Sharan Wadhwani, Stephan Ward, Arlo Whithouse, Deborah Wright, Hasan Al Chalabi, Ashish Bhalla, Jo Chmiel, Julie Edmonds, Jodie Fitzgerald, Nicole Isitt, Jonathan Lund, Nicole Mckee, Joely Morgan, Elizabeth Nadin, Ellie Piggott, Rajeev Singh, Katherine Smith, William Speake, Peter Thurley, Samson Tou, Christ Worth, Jill Cooke, Rachel Plummer, Baljit Singh, Ratan Verma, Ndkeita Barnett, Adrian Butler, Susan Gallagher, Amanda Hall, Kar Wai Lau, Mia Marsden, Michael Martin, Katrina Parkinson, Rochelle Rhodes, Alison Tilley, Janine Mallinson, Tania Neale, Ian Renwick, Jacqui Smith, Alison Turnbull

  • September 17, 2025

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