Does the diameter of colonic stent influence the outcomes in bridge-to-surgery patients with malignant large bowel obstruction?

Surgery Today ◽  
2020 ◽  
Author(s):  
Akihisa Matsuda ◽  
Takeshi Yamada ◽  
Goro Takahashi ◽  
Tetsutaka Toyoda ◽  
Satoshi Matsumoto ◽  
...  
2020 ◽  
Vol 102 (2) ◽  
pp. 141-143
Author(s):  
A Lazzaro ◽  
A Saini ◽  
C Elton ◽  
GK Atkin ◽  
IC Mitchell ◽  
...  

Introduction Colonic stent insertion has been shown to be an effective treatment for patients with acute large bowel obstruction, either as a bridge to surgery or as definitive treatment. However, little is known of the role of secondary stent insertion following primary stent failure in patients considered inappropriate or high risk for emergency surgery. Methods Fourteen patients presenting with acute large bowel obstruction who had previously been treated with colonic stent insertion were studied. All underwent attempted placement of a secondary stent. Results Technical deployment of the stent was accomplished in 12 patients (86%) but only 9 (64%) achieved clinical decompression. Successful deployment and clinical decompression of a secondary stent was associated with older age (p=0.038). Sex, pathology, site of obstruction, duration of efficacy of initial stent and cause of primary failure were unrelated to outcome. No procedure related morbidity or mortality was noted following repeated intervention. Conclusions Secondary colonic stent insertion appears an effective, safe treatment in the majority of patients presenting with acute large bowel obstruction following failure of a primary stent.


2014 ◽  
Vol 22 (2) ◽  
pp. 497-504 ◽  
Author(s):  
Akihisa Matsuda ◽  
Masao Miyashita ◽  
Satoshi Matsumoto ◽  
Takeshi Matsutani ◽  
Nobuyuki Sakurazawa ◽  
...  

2020 ◽  
Vol 35 ◽  
pp. 399-405
Author(s):  
L. Mora-López ◽  
M. Hidalgo ◽  
J. Falcó ◽  
Sh Serra-Pla ◽  
A. Pallisera-Lloveras ◽  
...  

2014 ◽  
Vol 79 (5) ◽  
pp. AB250
Author(s):  
Jensen T. Poon ◽  
Steffi Yuen ◽  
Dominic Foo ◽  
Wai-Lun Law

2019 ◽  
Vol 3 ◽  
pp. AB045-AB045
Author(s):  
Noel Edward Donlon ◽  
Michael Eamon Kelly ◽  
Paul Hugh McCormick ◽  
Fady Narouz ◽  
John Larkin ◽  
...  

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
Y Embury-Young ◽  
F Caslake Holding ◽  
E Wates ◽  
J Shabbir

Abstract Introduction The National Institute of Clinical Excellence (NICE) updated guidance in January 2020 and recommend colonic stent insertion for acute left-sided bowel obstruction as either palliative treatment or a bridge to elective surgery. Colonic stent insertion has shown improved outcomes in reducing hospital stay and stoma rate when compared to emergency surgery in patients presenting with large bowel obstruction. Objectives This service evaluation aimed to identify indications, complications, and outcomes of colonic stent insertion at University Hospital Bristol(UHB). Method Retrospective analysis of all colonic stent procedures performed at UHB between 1st January 2010 to 31st May 2020. Results 87 patients had a colonic stent procedure. 60(69%) were performed as an emergency and 27(33%) electives. Obstruction was secondary to a tumour in 84(97%) patients and diverticular strictures in 3(3%). 19(22%) had stent insertion as a bridge to elective surgery. 64(74%) stents were successfully deployed. 15(75%) required emergency surgery where the stent was unsuccessful. Complications occurred in 9(14%) successfully deployed stents, including: perforation(1;1%); per-rectal bleed(1;1%); dislodgement(1:1%); bacterial translocation(1;1%); tenesmus(2;2%); more than one stent required(3;3%). 30-day mortality was 11%. Conclusions The majority of colonic stent procedures at UHB were for patients presenting with acute large bowel obstruction secondary to malignancy. Few of these patients were suitable for surgery and stent insertion primarily for symptom relief. Where stent insertion is unsuccessful there is a high conversion (75%) to emergency surgery. Complications were observed in 14% of stent procedures and 30-day mortality was 11%.


2013 ◽  
Vol 79 (12) ◽  
pp. 1279-1282 ◽  
Author(s):  
Mehmet Karabulut ◽  
Koray Bas ◽  
Murat Gönenç ◽  
Mustafa Uygar Kalayci ◽  
Mehmet Abdussamet Bozkurt ◽  
...  

Endoscopic colonic stenting with self-expanding metallic stents is now widely used to treat malignant large bowel obstruction, where temporary or permanent decompression of the large bowel is desired. The medical records of patients who underwent endoscopic colonic stenting for malignant large bowel obstruction between May 2004 and May 2011 were reviewed. Success rate, morbidity, and mortality rate along with patient characteristics were documented. Sixty-seven patients were included. The procedure was used as a bridge to surgery in 38 and as a palliative measure in 29. Success rate was 95.5 per cent. Perforation and reobstruction occurred in three and three patients, respectively. All of the patients who developed perforation or reobstruction underwent emergency surgery. Endoscopic stenting offers a safe and effective treatment option in patients with malignant large bowel obstruction with comparable outcomes.


Sign in / Sign up

Export Citation Format

Share Document