A trial looking at relieving a blockage caused by bowel cancer with a tube inside the bowel (CReST)

Cancer type:

Bowel (colorectal) cancer

Status:

Results

Phase:

Phase 3

This trial looked at putting an expanding tube (a stent) inside the bowel instead of having emergency surgery when the bowel was blocked.

Cancer Research UK supported this trial. 

More about this trial

Bowel cancer is sometimes diagnosed because it causes a blockage in the bowel, which makes you very unwell. In this situation, you need to have emergency surgery to relieve the blockage and allow your bowel to start working again.

Surgery is one of the usual treatments for bowel cancer. But emergency surgery is more difficult than surgery that is planned. There is a higher risk of complications after surgery and it is more likely that you will need to have a colostomy (a stoma).

In this trial, the researchers wanted to see if it was possible to put a stent into the bowel to relieve the blockage (endoluminal stenting). This pushes the bowel open and allows the contents of the bowel to pass. If this worked, the doctors would have more time to plan surgery. And people might get a bit better before their operation.

The aims of the trial were to learn more about endoluminal stenting. And to see if it:

  • reduced complications of surgery and the length of time spent in hospital
  • helped people to live longer
  • meant fewer people needed a stoma
  • affected quality of life Open a glossary item

Summary of results

The trial team found that having a stent in place of emergency surgery reduced the number of people who needed to have a colostomy (stoma).

245 people took part in the trial. They were put into 1 of 2 groups at random.

  • 123 had a stent put in before surgery – they had surgery about 1 to 4 weeks later
  • 122 had emergency surgery

The trial team produced some early results in 2016. They found the stent worked in just over 8 out of 10 people (82%).

After surgery, the trial team looked at the number of people who had a colostomy. This was:

  • just under 5 out of 10 people (45%) who had a stent
  • just under 7 out of 10 people (69%) who had emergency surgery

CReST trial diagram

The trial team also looked at:

  • length of hospital stay and if anyone needed intensive care
  • the number of people living 1 year after treatment
  • quality of life

There was no difference between the 2 groups in any of these.

The trial team say these early results show that the stent could be a way of reducing the risk of people needing a colostomy. The trial team plan to follow up this work for 3 years to confirm these results.

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) but may not have been published in a medical journal. The figures we quote above were provided by the research team. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Jim Hill

Supported by

Cancer Research UK
Central Manchester University Hospitals NHS Foundation Trust
NIHR Clinical Research Network: Cancer
University of Birmingham

Other information

This is Cancer Research UK trial number CRUK/08/005.

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

1704

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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