Colorectal stenting for palliation and as a bridge to surgery: A 5-year follow-up study

Bayraktar, Baris; Özemir, İbrahim Ali; Kefeli, Umut; Demiral, Gökhan; Sağıroğlu, Jülide; Bayraktar, Onur; Adali, Güpse; Özçelik, Alp; Tortum, Osman Baran

doi:10.3748/wjg.v21.i31.9373

Cited by 16 publications

(6 citation statements)

References 26 publications

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“…With respect to colonic SEMS, a large prospective series of 513 patients and 6 retrospective studies found the risk of clinically relevant haemorrhage within 7 days to be 0 % 165 166 167 168 169 170 171 172 173 174 . A systematic review identifying 40 studies on SEMS for the management of emergency malignant large bowel obstruction identified 9 studies reporting on clinical relevant bleeding which occurred in 0.5 % (8 out of 1474 patients) 175 .…”

Section: Endoscopic Proceduresmentioning

confidence: 99%

Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update

et al. 2021

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This is a collaboration between the British Society of Gastroenterology (BSG) and the European Society of Gastrointestinal Endoscopy (ESGE), and is a scheduled update of their 2016 guideline on endoscopy in patients on antiplatelet or anticoagulant therapy. The guideline development committee included representatives from the British Society of Haematology, the British Cardiovascular Intervention Society, and two patient representatives from the charities Anticoagulation UK and Thrombosis UK, as well as gastroenterologists. The process conformed to AGREE II principles, and the quality of evidence and strength of recommendations were derived using GRADE methodology. Prior to submission for publication, consultation was made with all member societies of ESGE, including BSG. Evidence-based revisions have been made to the risk categories for endoscopic procedures, and to the categories for risks of thrombosis. In particular a more detailed risk analysis for atrial fibrillation has been employed, and the recommendations for direct oral anticoagulants have been strengthened in light of trial data published since the previous version. A section has been added on the management of patients presenting with acute GI haemorrhage. Important patient considerations are highlighted. Recommendations are based on the risk balance between thrombosis and haemorrhage in given situations.

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Section: Endoscopic Proceduresmentioning

confidence: 99%

Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update

et al. 2021

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“…Það er sambaerilegt við hlutfall þeirra BíAsjúklinga sem fengu stóma í rannsókn frá 2016 8 (22,2%) en hjá tveimur sjúklingum í þeirri rannsókn var stómanu síðar sökkt. Varanlegt stómahlutfall hjá BíAsjúklingum hefur í mismunandi rannsóknum verið metið á bilinu 040% 10,17,18 en mun ur er á uppsetningu og sjúklingahópum, þar með talið hlutfalli sjúklinga með endaþarmskrabbamein.…”

Section: Umraeðaunclassified

Stenting for colorectal cancer obstruction in Icelandic patients

Asbjarnardottir

Valsdóttir

Sigurðsson

et al. 2020

LBL

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Stenting for colorectal cancer obstruction in Icelandic patientsINTRODUCTION: Self-expandable metal stents (SEMS) are a known treatment option for obstruction due to colorectal cancer. The objective of this project was to estimate the usage of such stents in Iceland between 2000-2018. We evaluated the number of patients who received the stent as a bridge to surgery (BtoS) or as a palliative therapy (PT) and evaluated complication rate and the technical and clinical success rate.MATERIAL AND METHODS: Retrospective review of patients in Landspitali University Hospital who received SEMS for malignant colorectal obstruction. Search was conducted using diagnostic and theraputic codes in the Icelandic electronic medical record system. RESULTS: A total of 43 patients with colorectal cancer received in total 53 SEMS for obstruction, the first patient in 2005. More patient received SEMS as PT (n=27) than as BtoS (n=16). Colon perforation occurred in 5 patients (12%). A resection with primary anastomosis was performed in 69% of the BtoS patients. The majority of the PT patients did not receive an operation (63%). Permanent stoma ratio was 27% for BtoS patients and 22% for PT patients. CONCLUSION: SEMS served as BtoS with resection and primary anastomosis for the majority of patients in the BtoS group. For a majority of patients in the PT group, SEMS could be used to avoid surgery. The perforation rate was relatively high. Information on techincal and clinical success was poorly recorded. Because of the retrospective nature of the study and the small population size all results should be interpreted with caution.

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“…On the other hand, in patients with advanced stage CRC, SEMS placement can avoid a permanent stoma and result in lower morbidity, shorter hospitalisation, earlier start of chemotherapy and similar survival compared to surgery. In the palliative setting, when the expansion is satisfactory after 48 h, 80% and 72% of SEMS remain patent after 6 and 12 months, respectively [9–14].…”

Section: Stents In the Management Of Colorectal Carcinomamentioning

confidence: 99%

Endoscopic stenting of malignant, benign and iatrogenic colorectal disorders: a primer for radiologists

2019

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In recent years, endoscopic placement of intraluminal stents is increasingly used to manage a widening range of colorectal disorders. Self-expanding metal stents represent an established alternative to surgery for the palliation of unresectable carcinomas and currently allow a “bridge-to-surgery” strategy to relieve large bowel obstruction and optimise the patients’ clinical conditions before elective oncologic resection. Additionally, intraluminal stents represent an appealing option to manage obstructing extracolonic tumours and selected patients with benign conditions such as refractory anastomotic strictures and post-surgical leaks. This educational paper reviews the technical features and current indications of colorectal stenting and presents the expected and abnormal radiographic, CT and MRI appearances observed during the endoscopic management of malignant, benign and iatrogenic colonic disorders with stents. The aim is to provide radiologists with a thorough familiarity with stent-related issues, which is crucial for appropriate reconstruction of focused CT images, correct interpretation of early post-procedural studies and elucidation of stent-related complications such as misplacement, haemorrhage, perforation, migration and re-obstruction.

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Colorectal stenting for palliation and as a bridge to surgery: A 5-year follow-up study

Abstract: The efficacy and safety of colonic stents was demonstrated both as a bridge to surgery and for palliative decompression. In addition, results emphasize the importance of the skills of the endoscopist in colonic stenting.

Cited by 16 publications

References 26 publications

Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update

Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update

Stenting for colorectal cancer obstruction in Icelandic patients

Endoscopic stenting of malignant, benign and iatrogenic colorectal disorders: a primer for radiologists

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