Colonic Stenting for Nonmalignant Large Bowel Obstruction to Avoid Emergency Decompressive Surgery

2021 ◽  
pp. 000313482199868
Author(s):  
Alex Zhornitskiy ◽  
Felicia Zhornitsky ◽  
Formosa C. Chen ◽  
James H. Tabibian
Keyword(s):  
Bowel Obstruction ◽  
Large Bowel ◽  
Elective Surgery ◽  
Case Series ◽  
Large Bowel Obstruction ◽  
Permanent Colostomy ◽  
Stoma Creation ◽  
Colonic Stenting ◽  
Patient Vignette ◽  
Emergent Surgery

Self-expanding metallic stents (SEMSs) are frequently used to decompress malignant large bowel obstruction (LBO) and avoid emergent surgery with often permanent colostomy creation. However, limited data are available on the use and outcomes of SEMS in patients with nonmalignant LBO. We present a case series of 4 patients who were found to have nonmalignant LBO for which they underwent emergent colonic stenting as a bridge to elective surgery following interdisciplinary discussion between gastroenterology, colorectal surgery, and radiology. Through each patient vignette, we illustrate the use of SEMSs as a potential alternative to emergent surgery. 2 of 4 patients avoided stoma creation at the time of surgery, and 1 patient avoided surgery altogether; overall, however, the outcomes of this approach were mixed in this series, indicating a need for further investigation to better identify the patient population that would benefit most from initial SEMS placement for decompression of nonmalignant LBO.

scholarly journals Colonic stenting in malignant large bowel obstruction

2016 ◽  
Vol 4 (6) ◽  
pp. 616-617
Author(s):  
Vinita A. Rajadurai ◽  
Michael Levitt
Keyword(s):  
Bowel Obstruction ◽  
Large Bowel ◽  
Large Bowel Obstruction ◽  
Colonic Stenting

scholarly journals AB045. 7. Colonic stenting as a bridge to surgery in malignant large bowel obstruction: oncological outcomes

2019 ◽  
Vol 3 ◽  
pp. AB045-AB045
Author(s):  
Noel Edward Donlon ◽  
Michael Eamon Kelly ◽  
Paul Hugh McCormick ◽  
Fady Narouz ◽  
John Larkin ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Large Bowel ◽  
Large Bowel Obstruction ◽  
Bridge To Surgery ◽  
Oncological Outcomes ◽  
Colonic Stenting

scholarly journals 689 A Service Evaluation of Colonic Stent Procedures Over A 10 Year Period at University Hospital Bristol

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
Y Embury-Young ◽  
F Caslake Holding ◽  
E Wates ◽  
J Shabbir
Keyword(s):  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Large Bowel ◽  
Elective Surgery ◽  
Symptom Relief ◽  
Service Evaluation ◽  
Large Bowel Obstruction ◽  
University Hospital ◽  
Stent Insertion ◽  
Colonic Stent

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%.

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 ◽  
...  
Keyword(s):  
Success Rate ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Patient Characteristics ◽  
Large Bowel Obstruction ◽  
Metallic Stents ◽  
Endoscopic Stenting ◽  
Bridge To Surgery ◽  
Effective Treatment Option ◽  
Colonic Stenting

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.

Colonic Stenting as a Bridge to Surgery in Malignant Large-Bowel Obstruction: A Report from Two Large Multinational Registries

2011 ◽  
Vol 106 (12) ◽  
pp. 2174-2180 ◽  
Author(s):  
J Jiménez-Pérez ◽  
J Casellas ◽  
J García-Cano ◽  
J Vandervoort ◽  
Roncero O García-Escribano ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Large Bowel ◽  
Large Bowel Obstruction ◽  
Bridge To Surgery ◽  
Colonic Stenting

scholarly journals Colonic stenting for a malignant large bowel obstruction with pneumatosis coli to reduce surgical risk

2018 ◽  
Vol 31 (4) ◽  
pp. 462-464
Author(s):  
Ronney F. Stadler ◽  
Matthew R. Hughes ◽  
Jefferson B. Hurley ◽  
Randall W. Crim
Keyword(s):  
Bowel Obstruction ◽  
Large Bowel ◽  
Large Bowel Obstruction ◽  
Pneumatosis Coli ◽  
Surgical Risk ◽  
Colonic Stenting
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