Endoscopic placement of self-expandable metal stents for malignant colonic obstruction: long-term outcomes and complication factors

Small, Aaron J.; Coelho–Prabhu, Nayantara; Baron, Todd H.

doi:10.1016/j.gie.2009.10.012

Cited by 286 publications

(298 citation statements)

References 37 publications

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“…Technical and clinical success rates of SEMS insertion are reported as 94% and 91%, respectively, with negligible SEMS-related mortality. [6][7][8][9] According to these studies, colonic stent placement was found to be a relatively safe technique with a high success rate. In the present study, technical and clinical success rates of SEMS insertion were comparable to those reported in the literature, at 92.8% and 90.4%, respectively.…”

Section: Discussionmentioning

confidence: 99%

The role of colorectal stent placement in the management of acute malignant obstruction

Yanar¹,

Özçınar²,

Yanar³

et al. 2014

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

The role of colorectal stent placement in the management of acute malignant obstruction

Yanar¹,

Özçınar²,

Yanar³

et al. 2014

Ulus Travma Acil Cerrahi Derg

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“…15 It is suggested that dilatation may adversely affect patient outcomes following SEMS. [21][22][23] Systematic review and meta-analysis of retrospective data suggests an increased risk of perforation colonic perforation with stricture dilatation. 24,25 Enteral SEMS may be covered or uncovered.…”

Section: General Considerations and Techniquementioning

confidence: 99%

“…Stent diameter of less than 24 mm increases the risk of stent related complications (perforation, re-obstruction and migration), especially stent migration. 21,22 Whilst stent length per se does not seem to be important, the ESGE guidance is that the stent should traverse the stricture such that it extends 20 mm either side (after deployment). 15 As with all technical procedures, there is a learning curve for colonic SEMS placement.…”

Section: 27mentioning

confidence: 99%

“…15 As with all technical procedures, there is a learning curve for colonic SEMS placement. Retrospective series 22,28 and noncomparative studies 29,30 have shown that stent outcome is affected by operator experience. Technical success rate (and use of fewer stents) significantly improves after 20 procedures.…”

Section: 27mentioning

confidence: 99%

“…Retrospective series suggested an increased perforation rate in those treated with bevacizumab (an angiogenesis inhibitor) (17%-50%). 22,57,59 A recent meta-analysis investigated risk factors for increased perforation rate. 25 Chemotherapy without bevacizumab was not associated with a significantly increased risk (7.0%), but use of bevacizumanb was (12.5%).…”

Section: Palliative Semsmentioning

confidence: 99%

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Colonic cancer: The current role of stent insertion

Newton

Hill

2017

Int J Gastrointest Interv

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Acute colonic obstruction secondary to left-colonic malignancy remains a common emergency condition. Traditional management is emergency surgery and has high morbidity and mortality. Self expandable metallic stents (SEMS) promised to improve morbidity and mortality, stoma rates and hospital stay. SEMS use in the potentially curative setting, as a bridge to surgery, is associated with an improved stoma rate and morbidity, but has no mortality benefit. There are concerns about oncological safety with higher local recurrence rates, thus SEMS is not recommended in this setting unless the patient has increased surgical risk and would benefit from a period of recovery prior to surgery. SEMS has a definite role in the palliative setting, for both patients with incurable disease or those with a high surgical risk. SEMS is associated with improved morbidity, mortality, and stoma rates. The technique for SEMS insertion is now well established but it is still unclear whether covered or uncovered stents are better.

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Endoscopic Palliation in Patients With Incurable Malignant Colorectal Obstruction by Means of Self-expanding Metal Stent

et al. 2011

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To evaluate the short-and long-term efficacy of self-expanding metal stents (SEMSs) in patients with colorectal obstruction and incurable cancer and the related factors that affect outcomes. Design: Retrospective analysis of SEMS placement for incurable colorectal obstruction in a 3-year period. Setting: Five tertiary care endoscopic centers. Patients and Intervention: Consecutive patients (N=201) undergoing stenting for incurable malignant obstruction. Main Outcome Measurements: Clinical and technical success of stenting, complications rate, and factors affecting outcomes. Results: Technical success was achieved in 184 of 201 patients (91.5%) and clinical success occurred in 165 of 184 patients (89.7%; 82.1% of 201 patients). Technical

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Endoscopic placement of self-expandable metal stents for malignant colonic obstruction: long-term outcomes and complication factors

Cited by 286 publications

References 37 publications

The role of colorectal stent placement in the management of acute malignant obstruction

The role of colorectal stent placement in the management of acute malignant obstruction

Colonic cancer: The current role of stent insertion

Endoscopic Palliation in Patients With Incurable Malignant Colorectal Obstruction by Means of Self-expanding Metal Stent

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