Radiological Position and Clinical Outcome of Preoperative Self-Expanding Metal Stents for Obstructing Colonic Cancer: A Single-Centre Cohort Study

2015 ◽  
Vol 32 (4) ◽  
pp. 262-268 ◽  
Author(s):  
Eline H. van den Berg ◽  
Jilling F. Bergmann ◽  
Michiel Ledeboer ◽  
Rob A.J.M. van Dijk ◽  
Robbert J.I. Bosker ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Clinical Success ◽  
Emergency Operation ◽  
Metal Stents ◽  
Single Centre ◽  
Urgent Surgery ◽  
Single Centre Study ◽  
Colonic Stents ◽  
Self Expanding Metal Stents ◽  
The Subject

Background: Preoperative placement of self-expanding metal stents is used in patients with obstructing colon carcinoma to prevent an emergency operation. The perceived benefits remain the subject of discussion. The data-evaluating function and complications of stents in relation to radiological position are limited. Methods: Patients receiving a preoperative stent between 2003 and 2013 were retrospectively analysed in this single-centre study. We analysed radiological deployment, eccentricity and angulation of the stent directly after placement. Endpoints were clinical success (resolution of ileus), complications needing non-elective surgery (blow-out, perforation, persistent ileus, dislocation) and other complications (bleeding, infiltrate). Associations were corrected for other potential influences. Results: Eighty-two patients were included. In 22 patients (26.8%), the stent was placed proximal to the splenic flexure. Clinical success was present in 85.4%. Twenty-two patients (26.8%) had a complication of which 16 (19.5%) underwent urgent surgery for insufficient functioning of the stent; there were two blow-outs (2.4%). A more symmetrically placed stent was associated with clinical success (p = 0.042), with large overlap between groups. However, no association was found with non-elective surgery or complications. Also, angulation and deployment were unassociated with these outcomes. Conclusions: We could not establish an association between symmetry, angulation or deployment of self-expandable colonic stents with clinical success and complications.

scholarly journals 755 Elective Surgery in the COVID-19 Pandemic: Outcomes of 100 Consecutive Cases

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Fisher ◽  
C Hadjittofi ◽  
Z Ali ◽  
P Antonas ◽  
K Parekh ◽  
...  
Keyword(s):  
Pain Management ◽  
Oral Surgery ◽  
Elective Surgery ◽  
University Hospital ◽  
Single Centre ◽  
Median Length ◽  
Microsoft Excel ◽  
Single Centre Study ◽  
Green Zone

Abstract Introduction The COVID-19 pandemic halted elective surgical activity. Basildon University Hospital established an elective Green Zone for COVID-19 swab negative patients who isolated for 14 days. This study reviewed the outcomes of the first 100 patients. Method A single-centre study was performed. Demographic and perioperative electronic data were supplemented with telephone follow-up for the first 100 Green Zone patients and analysed in Microsoft Excel. Results One hundred Green Zone patients underwent surgery between 21/05/2020 and 16/06/2020. The median age was 55 (14-88) years. 52% were female. Their operations were performed by General Surgery (39%), Gynaecology (17%), Vascular Surgery (14%), Oral Surgery (12%), ENT (9%), Urology (8%), and Pain Management (1%). Preoperatively, 100% had a negative SARS-CoV-2 swab and one had CT evidence of mild resolving COVID-19. Two patients had postoperative SARS-CoV-2 swabs, both negative. Median length of stay was 0 (0-7) days. 84% responded to telephone follow-up at a median 25 (13-54) postoperative days, 69% of whom were asymptomatic There were no 30-day major complications (>Clavien-Dindo IIIa) or 90-day mortality. Conclusions Elective surgery can be safe during the COVID-19 pandemic, with appropriate measures in place. This has significant implications in the context of an ever-expanding NHS waiting list during a pandemic of uncertain duration.

Severe Complications Limit Long-Term Clinical Success of Self-Expanding Metal Stents in Patients With Obstructive Colorectal Cancer

2010 ◽  
Vol 105 (5) ◽  
pp. 1087-1093 ◽  
Author(s):  
Gloria Fernández-Esparrach ◽  
J M Bordas ◽  
M D Giráldez ◽  
A Ginès ◽  
M Pellisé ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Success ◽  
Metal Stents ◽  
Obstructive Colorectal Cancer ◽  
Self Expanding Metal Stents

V1.2.5 SELF-EXPANDING METAL STENTS FOR MALIGNANT COLORECTAL OBSTRUCTION: A SINGLE CENTRE EXPERIENCE

2008 ◽  
Vol 40 ◽  
pp. S74
Author(s):  
R. Forlano ◽  
A. Andriulli ◽  
P. Di Sebastiano ◽  
N. Mastrodonato ◽  
G. Procaccini ◽  
...  
Keyword(s):  
Metal Stents ◽  
Single Centre ◽  
Colorectal Obstruction ◽  
Single Centre Experience ◽  
Self Expanding Metal Stents

scholarly journals Fully covered self-expanding metal stents for refractory pancreatic duct strictures in symptomatic chronic pancreatitis, US experience

2019 ◽  
Vol 07 (11) ◽  
pp. E1419-E1423 ◽  
Author(s):  
Reem Z. Sharaiha ◽  
Aleksey Novikov ◽  
Kristen Weaver ◽  
Pawan Marfatia ◽  
Jonathan M. Buscaglia ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Success Rate ◽  
Pancreatic Duct ◽  
Clinical Success ◽  
Tertiary Care ◽  
Plastic Stents ◽  
Metal Stents ◽  
Technical Success ◽  
Self Expanding Metal Stents

Abstract Background and study aims Fully covered self-expanding metal stents (FCSEMS) have been used to treat refractory pancreatic duct strictures. We aimed to evaluate the feasibility, safety, and efficacy of FCSEMS in chronic pancreatitis with refractory pancreatic duct strictures. Patients and methods This was a retrospective multicenter cases series of patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with FCSEMS placement in the main pancreatic duct (MPD) at five tertiary care centers between February 2010 and June 2016. Primary endpoints were technical success, clinical success, and procedure-related morbidity. Secondary endpoints were pain relief at the end of follow-up and resolution of the pancreatic stricture on ERCP. Results Thirty-three patients with previously drained stents, 76 % of whom were male, underwent ERCP with FCSEMS placement. Mean duration of follow-up was 14 months. All of the patients had prior therapy. The technical success rate for FCSEMS placement was 100 % (n = 33) and the clinical success rate was 93 % (was n = 31). Stents were removed after a median duration of 14.4 weeks. After stent removal, the diameter of the narrowest MPD stricture had increased significantly from 1 mm to 4.5 mm (P < 0.001). There was a statistically significant improvement on the Visual Analogue Scale (VAS) from a median of 8.5 to 2.5. At the end of the study, (n = 27) 87.1 % of patients reported significant pain reduction with reduced narcotic use. Conclusion FCSEMS appeared to be a feasible, safe, and potentially effective Intervention in patients who had not responded to endoscopic therapy with plastic stents.

scholarly journals Endosonography-guided drainage of loculated malignant ascites using double-pigtail plastic stents

2018 ◽  
Vol 06 (07) ◽  
pp. E902-E906 ◽  
Author(s):  
Reiner Köck ◽  
Christian Jürgensen ◽  
Rupert Fischer-Lampsatis
Keyword(s):  
Clinical Success ◽  
Treatment Options ◽  
Symptom Control ◽  
Malignant Ascites ◽  
Plastic Stents ◽  
Metal Stents ◽  
Self Expanding Metal Stents ◽  
Clinically Significant ◽  
Fluid Collections

Abstract Background and study aims Endoscopic ultrasound (EUS)-guided drainage is a well-established procedure for peripancreatic fluid collections (PFC) that develop in the context of acute pancreatitis or following pancreatic surgery. Malignant ascites can occur in a loculated form resembling PFC causing a variety of symptoms, with limited treatment options. There is a paucity of data about application of EUS-guided drainage for these kinds of fluid collections. So far, only one report exists describing clinical success in three cases, using fully-covered self-expanding metal stents (FCSEMS). FCSEMS, however, have possible drawbacks, particularly if they have to remain in place for an indeterminate period of time. Herein, we describe EUS-guided drainage of loculated malignant ascites using double-pigtail plastic stents in two patients severely symptomatic from esophagogastric obstruction symptoms. Technical and clinical success was achieved in both cases without clinically significant complications including one case, where ongoing symptom control could be observed after 6 months of follow-up.

Limited Long-Term Clinical Success of Self-Expanding Metal Stents in Patients with Obstructive Colorectal Cancer

2009 ◽  
Vol 69 (5) ◽  
pp. AB296-AB297
Author(s):  
Gloria Fernandez-Esparrach ◽  
Josep M. Bordas ◽  
Maria Dolores Giraldez ◽  
Miguel Camacho ◽  
Leonel Zavala ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Success ◽  
Metal Stents ◽  
Obstructive Colorectal Cancer ◽  
Self Expanding Metal Stents
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