Self-expanding Metallic Stents in Acute Mechanical Intestinal Obstructions Resulting from Colorectal Malignancies

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.

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

2011 ◽  
Vol 106 (12) ◽  
pp. 2174-2180 ◽  
Author(s):  
J Jiménez-Pérez ◽  
J Casellas ◽  
J García-Cano ◽  
J Vandervoort ◽  
Roncero O García-Escribano ◽  
...  

2009 ◽  
Vol 98 (3) ◽  
pp. 143-147 ◽  
Author(s):  
H.-C. Pommergaard ◽  
P. Vilmann ◽  
H. L. Jakobsen ◽  
M. P. Achiam

Background and Aims: Self-expanding metallic stents (SEMS) have since 1991 established themselves as an option in the treatment of large bowel obstruction. The aim of this study was to evaluate the use of SEMS in management of acute colorectal obstructions at a Danish Surgical Gastroenterology center. Material and Methods: Retrospective review of charts from all patients who, in the period Marts 2002 to December 2007 underwent insertion of a SEMS for an acute large bowel obstruction. Results: Of 45 patients included, SEMS was intended as a bridge to surgery in 20 patients and as palliation in 25 patients. For malignant etiology, the SEMS procedure was a technical and clinical success in 97.4% of the cases. Complications occurred in 21%, mortality rate 2,6%. For benign etiology, the SEMS procedure was a technical success in 85.7%, and a clinical success in 71.4%. Complications occurred in 71.4% of the benign cases with a mortality rate of 28,6%. Conclusions: placement of SEMS for acute large bowel obstruction with malignant etiology is an effective and safe procedure with low mortality and morbidity. However results for benign obstructions are questionable and more research is needed to determine the role of SEMS.


2019 ◽  
Vol 34 (4) ◽  
pp. 613-619 ◽  
Author(s):  
N. E. Donlon ◽  
M. E. Kelly ◽  
F. Narouz ◽  
P. H. McCormick ◽  
J. O. Larkin ◽  
...  

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Niccolò Allievi ◽  
Marco Ceresoli ◽  
Paola Fugazzola ◽  
Giulia Montori ◽  
Federico Coccolini ◽  
...  

Introduction. Emergency resection represents the traditional treatment for left-sided malignant obstruction. However, the placement of self-expanding metallic stents and delayed surgery has been proposed as an alternative approach. The aim of the current meta-analysis was to review the available evidence, with particular interest for the short-term outcomes, including a recent multicentre RCT. Methods. We considered randomized controlled trials comparing stenting as a bridge to surgery and emergency surgery for the management of left-sided malignant large bowel obstruction, performing a systematic review in MEDLINE, PubMed database, and the Cochrane libraries. Results. We initially identified a total of 2543 studies. After the elimination of duplicates and the screening of titles and abstracts, seven studies, for a total of 448 patients, were considered. The current meta-analysis revealed no difference in the mortality rate between the stent group and the emergency surgery group; the postoperative complication rate (37.84% versus 54.87%, P=0.02), the stoma rate (28.8% versus 46.02%, P<0.0001), and the incidence of wound infection (8.11% versus 15.49%, P=0.01) were reduced after stent as a bridge to surgery. Conclusion. Colonic stenting as a bridge to surgery appears to be a safe approach to malignant large bowel obstruction. Possible advantages of this treatment can be identified in a reduced incidence of postoperative complications and a lower stoma rate. Further RCTs considering long-term outcomes and cost-effectiveness analysis are needed.


Sign in / Sign up

Export Citation Format

Share Document