scholarly journals Robot-assisted laparoscopic surgery after placing a self-expanding metallic stent for malignant rectal obstruction: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Hiroshi Takeyama ◽  
Katsuki Danno ◽  
Takahiko Nishigaki ◽  
Masafumi Yamashita ◽  
Masami Yamazaki ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Lower Abdominal Pain ◽  
Lower Limbs ◽  
Metallic Stent ◽  
Sems Placement ◽  
Robot Assisted ◽  
Colorectal Obstruction ◽  
First Report ◽  
Distended Bowel ◽  
Rectal Obstruction

Abstract Background Approximately 20% of colorectal cancer patients show complete or incomplete bowel obstruction as an early symptom. Preoperative nonsurgical decompression such as placing a self-expanding metallic stent for malignant colorectal obstruction has been shown to be effective for reducing perioperative morbidity and mortality. However, there is a lack of published studies reporting robot-assisted laparoscopic surgery (RALS) after self-expanding metallic stent (SEMS) placement for malignant rectal obstruction (MRO). To our knowledge, this is the first report to do so. Case presentation An 80-year-old man with incomplete paralysis of the lower limbs as well as bladder–rectal disorder due to a spine fracture sustained in a fall accident 26 years ago presented with lower abdominal pain and vomiting. Abdominal multi-detector computed tomography revealed an obstructive rectal tumor with distended bowel on the oral side. Emergency colonoscopy was performed, and an SEMS placed. The patency of SEMS and decompression of the distended bowel was confirmed, and elective RALS was performed 29 days after SEMS placement. To our knowledge, this is the first report of RALS after decompression with SEMS placement for MRO. Conclusions RALS after SEMS placement is a safe and feasible therapeutic strategy for MRO.

Metallic Stent for Malignant Colorectal Obstruction

2018 ◽  
Vol 02 (01) ◽  
pp. 046-052
Author(s):  
Yoshitaka Inaba ◽  
Yozo Sato
Keyword(s):  
Stent Migration ◽  
Late Complications ◽  
Secondary Outcome ◽  
Successful Implementation ◽  
Metallic Stent ◽  
Bridge To Surgery ◽  
Success Rates ◽  
Sems Placement ◽  
Colorectal Obstruction ◽  
Expandable Metallic Stent

AbstractAcute colorectal obstruction has been often reported as a secondary outcome of left-colonic malignancy. It is considered as a common emergency condition. Self-expandable metallic stent (SEMS) placement is widely used as a palliative treatment for the management of malignant colorectal obstruction (MCRO). SEMS placement is also deliberated as a bridge to surgery. With advances in technology, several recent studies of SEMS placement for MCRO indicated high technical (94–98%) and clinical (91–93%) success rates. The complication rate associated with SEMS is quite acceptable. However, long-term outcomes are still unclear. The symptoms should be carefully monitored before application of SEMS, particularly in patients who are eligible for systemic chemotherapy and in patients with a long life expectancy because of late complications such as reobstruction, stent migration, and perforation. Appropriate patient selection and placement technique are keys for the successful implementation of SEMS.

scholarly journals Effectiveness and safety of metallic stent for ileocecal obstructive colon cancer: a report of 4 cases

2017 ◽  
Vol 05 (09) ◽  
pp. E834-E838 ◽  
Author(s):  
Tatsuya Ishii ◽  
Kosuke Minaga ◽  
Satoshi Ogawa ◽  
Maiko Ikenouchi ◽  
Tomoe Yoshikawa ◽  
...  
Keyword(s):  
Metallic Stent ◽  
Bridge To Surgery ◽  
Sems Placement ◽  
Short Term ◽  
Endoscopic Retrograde ◽  
Ileocecal Region ◽  
Colorectal Obstruction ◽  
Decompression Tube ◽  
The Right ◽  
Expandable Metallic Stents

Abstract Background and study aims Self-expandable metallic stents (SEMS) have been widely used for left-sided colorectal obstruction. Few studies on SEMS placement for right-sided colonic obstructions have been reported because stenting in the right colon is technically difficult, particularly in the ileocecal region. We present 4 cases of successful bridge-to-surgery stenting for ileocecal cancer. Using an endoscopic retrograde cholangiopancreatography catheter with a movable tip and a decompression tube was effective for stenting. No adverse events occurred during or after SEMS placement in any of these cases. Short-term stenting for ileocecal cancer seems to be effective and safe.

scholarly journals Biopsy sampling during self-expandable metallic stent placement in acute malignant colorectal obstruction: a narrative review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sigrid Skov Bennedsgaard ◽  
Lene Hjerrild Iversen
Keyword(s):  
Cochrane Library ◽  
Unknown Etiology ◽  
Metallic Stent ◽  
Sems Placement ◽  
Colorectal Obstruction ◽  
Technical Success Rate ◽  
Expandable Metallic Stent ◽  
Real Risk ◽  
Acute Malignant Colorectal Obstruction ◽  
Risk Of Hemorrhage

Abstract Background Histopathology is a crucial part of diagnosis and treatment guidance of colorectal cancer. In Denmark, it is not routine to biopsy during self-expandable metallic stent (SEMS) placement as a treatment option for acute colorectal obstruction of unknown etiology. This is due to lack of knowledge about the risks of hemorrhage, and thus the risk to aggravate the deteriorating overview conditions. Therefore, the aim of this study is to investigate whether there is evidence to avoid biopsy sampling during acute SEMS placement. Methods The PubMed, Embase, and Cochrane Library databases were searched for relevant studies. Studies were included if they described biopsy sampling in relation to SEMS placement. Additionally, national and international guidelines were scrutinized on Google and by visiting the websites of national and international gastrointestinal societies. Results In total, 43 studies were included in the review. Among these, one recommended biopsy during SEMS placement, three advised against biopsy, 23 just reported biopsy was performed during the procedure, and 16 reported biopsy before or after the procedure, or the timing was not specified. Among the 12 included guidelines, only two described biopsy during SEMS placement. Conclusion The literature on the subject is limited. In 24 of the 43 included studies, biopsy sampling was done during SEMS placement without reporting a decrease in the technical success rate. The included guidelines were characterized by a general lack of description of whether biopsy during SEMS placement should be performed or not. Prospective studies are needed in order to establish the real risk of hemorrhage, if any, when a biopsy is obtained.

scholarly journals Reocclusion after Self-Expandable Metallic Stent Placement for Relieving Malignant Colorectal Obstruction as a Palliative Treatment

2016 ◽  
Vol 10 (3) ◽  
pp. 733-742 ◽  
Author(s):  
Toshikatsu Nitta ◽  
Kensuke Fujii ◽  
Yoshimasa Hirata ◽  
Tomo Tominaga ◽  
Yoshihiro Inoue ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Stent Placement ◽  
Emergency Operation ◽  
Metallic Stent ◽  
Sems Placement ◽  
Laboratory Findings ◽  
Colorectal Obstruction ◽  
Expandable Metallic Stent ◽  
Old Japanese ◽  
Good Treatment Option

Self-expandable metallic stent (SEMS) placement has been practiced in several hospitals in Japan, including ours, since January 2012. Here, we report the case of an 82-year-old Japanese man who presented to the hospital with a 1-week history of right hypochondrial pain. Computed tomography (CT) findings indicated colorectal cancer. The laboratory findings on admission indicated severe anemia (red blood cell count, 426 × 104/μL; hemoglobin, 7.9 g/dL). We performed SEMS placement because the patient refused to undergo surgery. He did not attend any of the scheduled follow-up visits after SEMS placement. However, a year and a half after the SEMS placement, the patient attended the hospital because of difficulty in passing stool. A plain abdominal CT scan showed bowel reobstruction due to the ascending colon cancer after SEMS placement. We performed an emergency operation, ascending colostomy, on the same day. Colorectal stent placement may be a good treatment option for patients who refuse to undergo conventional therapeutic treatments or in those with unresectable colorectal cancer. Patients should be carefully followed up every few months after SEMS placement because of the risk of reocclusion.

AF.7 USE OF PURASTAT® FOR POST-SPHINCTEROTOMY BLEEDING REFRANTORY TO SELF-EXPANDABLE METALLIC STENT (SEMS) PLACEMENT: A CASE REPORT

2021 ◽  
Vol 53 ◽  
pp. S140-S141
Author(s):  
M. Sica ◽  
C. Abbatiello ◽  
M. Gagliardi ◽  
O. Labianca ◽  
G. Oliviero ◽  
...  
Keyword(s):  
Case Report ◽  
Metallic Stent ◽  
Sems Placement ◽  
Expandable Metallic Stent

scholarly journals Comparison of Short-Term Outcomes Between Robotic-Assisted and Laparoscopic Surgery in Colorectal Cancer

2018 ◽  
Vol 26 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Xiao-Long Zhu ◽  
Pei-Jing Yan ◽  
Liang Yao ◽  
Rong Liu ◽  
De-Wang Wu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Colorectal Surgery ◽  
Hospital Stay ◽  
Bowel Function ◽  
Postoperative Recovery ◽  
Postoperative Hospital Stay ◽  
Robot Assisted ◽  
Short Term ◽  
Robotic Colorectal Surgery

Aim. The robotic technique has been established as an alternative approach to laparoscopy in colorectal surgery. The aim of this study was to compare short-term outcomes of robot-assisted and laparoscopic surgery in colorectal cancer. Methods. The cases of robot-assisted or laparoscopic colorectal resection were collected retrospectively between July 2015 and October 2017. We evaluated patient demographics, perioperative characteristics, and pathologic examination. A multivariable linear regression model was used to assess short-term outcomes between robot-assisted and laparoscopic surgery. Short-term outcomes included time to passage of flatus and postoperative hospital stay. Results. A total of 284 patients were included in the study. There were 104 patients in the robotic colorectal surgery (RCS) group and 180 in the laparoscopic colorectal surgery (LCS) group. The mean age was 60.5 ± 10.8 years, and 62.0% of the patients were male. We controlled for confounding factors, and then the multiple linear model regression indicated that the time to passage of flatus in the RCS group was 3.45 days shorter than the LCS group (coefficient = −3.45, 95% confidence interval [CI] = −5.19 to −1.71; P < .001). Additionally, the drainage of tube duration (coefficient = 0.59, 95% CI = 0.3 to 0.87; P < .001) and transfers to the intensive care unit (coefficient = 7.34, 95% CI = 3.17 to 11.5; P = .001) influenced the postoperative hospital stay. The total costs increased by 15501.48 CNY in the RCS group compared with the LCS group ( P = .008). Conclusions. The present study suggests that colorectal cancer robotic surgery was more beneficial to patients because of shorter postoperative recovery time of bowel function and shorter hospital stays.

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