CReST2
Research type
Research Study
Full title
CReST 2 - Colorectal Endoscopic Stenting Trial 2
IRAS ID
215796
Contact name
James Hill
Contact email
Sponsor organisation
Central Manchester University Hospitals NHS Trust
Duration of Study in the UK
4 years, 7 months, 30 days
Research summary
Up to 40% of patients who develop colorectal cancer are either not fit enough for resectional surgery or have advanced disease. Treatment in these patients is palliative and aimed at prolonging life and maximising its quality.
A significant proportion of patients with colorectal cancer present as an emergency, where the cancer has caused a bowel blockage. Unless the blockage is relieved, the bowel perforates and the patient develops peritonitis. Surgery, if performed, is associated with increased mortality, prolonged hospital stay, increased stoma formation, reduced quality of life and patients are often unable to have chemotherapy.
An alternative to surgery for patients presenting with an obstruction is stent insertion across the blocked part of the bowel. The stent is made of a special metal which expands when inserted. The procedure does not require general anaesthetic, and when successful, provides immediate relief of symptoms, avoiding the need for surgery and a stoma.
When a stent is inserted into patients who are too unfit for major surgery or the cancer is too advanced for surgery, the stent is left in the patient indefinitely. Survival in these palliative patients is improving and about half the patients receiving chemotherapy will survive 18-24 months. Unfortunately, stent related complications are common, occurring in over one third of patients. Potential complications include bowel perforation, stent obstruction with recurrent blockage and stent migration. Two designs of stent are used in the UK; uncovered stents made of bare metal, and stents with a plastic covering designed to reduce the chances of stent blockage.
Currently there is insufficient information comparing the two stent designs in terms of relative risk of complications of each stent design and outcome related to patient's expectations and quality of life.
CReST2 will assess whether uncovered or covered stents are best for patients treated for palliation.
REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
17/NE/0027
Date of REC Opinion
1 Feb 2017
REC opinion
Favourable Opinion