A Clinical Evaluation of Endoscopicallyplaced Self-Expanding Metallic Stents in Patients with Acute Large Bowel Obstruction

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.

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

The American Surgeon ◽

10.1177/000313481307901220 ◽

2013 ◽

Vol 79 (12) ◽

pp. 1279-1282 ◽

Cited By ~ 1

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.

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Secondary colonic stent insertion in acute large bowel obstruction following primary stent failure

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0136 ◽

2020 ◽

Vol 102 (2) ◽

pp. 141-143

Author(s):

A Lazzaro ◽

A Saini ◽

C Elton ◽

GK Atkin ◽

IC Mitchell ◽

...

Keyword(s):

High Risk ◽

Bowel Obstruction ◽

Large Bowel ◽

Large Bowel Obstruction ◽

Definitive Treatment ◽

Stent Insertion ◽

Bridge To Surgery ◽

Duration Of Efficacy ◽

Colonic Stent

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.

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