Fracture of a Colonic Self-expandable Metallic Stent in Malignant Colonic Obstruction

Takao, Akinari; Tabata, Taku; Koizumi, Koichi; Kuwata, Go; Shibata, Satomi; Mori, Makiko; Chiba, Kazuro; Kuruma, Sawako; Onishi, Tomoko; Fujiwara, Takashi; Kamisawa, Terumi; Fujiwara, Junko; Arakawa, Takeo; Momma, Kumiko; Shimoyama, Tatsu; Takahashi, Keiichi

doi:10.2169/internalmedicine.9023-17

Cited by 5 publications

(3 citation statements)

References 11 publications

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“…Increasing the quality of life, soothing pain and reducing symptoms of advanced disease is crucial from both medical and ethical perspective [1,2]. Selection of appropriate treatment should be based on careful and individual assessment of both advantages and disadvantages of available methods, together with possible complications [3][4][5]. Intestinal obstruction is one of the most common symptoms affecting even every second patient with advanced gynecologic tumors located in the pelvis [6].…”

Section: Introductionmentioning

confidence: 99%

Palliative treatment of intestinal obstruction in patients with gynecologic malignancies — single center experience

et al. 2019

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Objectives: One of the common symptoms in patients with advanced gynecologic tumors is intestinal obstruction. Palliative management may include pharmacological treatment, stenting as well as surgical removal of obstruction cause. Selection of appropriate treatment should be based on careful and individual assessment of advantages, disadvantages and possible complications. The aim of the study was to analyze the effectiveness of non-invasive treatment in patients with gynecologic malignancies suffering from intestinal obstruction. Material and methods:It was a retrospective analysis of factors associated with primary non-invasive intestinal obstruction treatment effectiveness. Data were collected from medical records of 17 patients managed and followed-up in a single gynecologic oncology center due to endometrial cancer, fallopian tube cancer, uterine leiomyosarcoma, and ovarian cancer admitted to the ward because of symptomatic intestinal obstruction. Mean observation time lasted 40.6 months. Non-invasive treatment included fluid therapy, dexamethasone, buscolysin, mebeverine, ranitidine, simethicone, omeprazole, magnesium sulphate, semi-liquid diet, and parenteral nutrition. Characteristics including age, BMI, comorbidities, oncological treatment, histology type, stage, grade, presence of ascites, location of primary tumor and metastases were analyzed. Results:The number of obstruction episodes varied from 1 to 5. Mean time between multiple episodes lasted 3.2 months. 5 patients required surgical treatment. For the rest of the patients primary non-invasive treatment was sufficient.Conclusions: Most cases of bowel obstruction in patients with advanced gynecologic malignancies can be successfully managed without invasive treatment. Moreover, non-invasive obstruction management can be applied multiple times in case of recurrence.

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Section: Introductionmentioning

confidence: 99%

Palliative treatment of intestinal obstruction in patients with gynecologic malignancies — single center experience

et al. 2019

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“…Kadokura et al (10) suggested that it may be useful to select a stent with a stronger axial force or to select a shorter stent to reduce the risk of fracture in cases of short stenosis in bending sites, such as at the gastric outlet (prepyloric region to the duodenum). Takao et al (11) also presumed that prolonged friction between the stenotic and non-stenotic sections might have triggered stent fracture, and the inappropriate length and low axial force of the stent at the flexure led to stent fracture in a fracture case with colonic SEMS. Jin et al (12) showed that the incidence of stent fracture was 1.8% and 0.9% in the clinical outcomes of primary stenting and re-stenting for mGOO, respectively.…”

Section: Discussionmentioning

confidence: 99%

Small Bowel Obstruction Caused by Migration of Fractured Metal Stent in Patients with Malignant Gastric Outlet Obstruction: A Report of Two Cases and Review of the Literature

Fujikawa,

Saigusa,

Aono

et al. 2024

Intern. Med.

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Gastroduodenal stenting (GDS) is a less invasive alternative to gastrojejunostomy for the management of malignant gastric outlet obstruction (mGOO). GDS is a minimally invasive treatment with good technical and clinical success, and severe complications that require surgical intervention are rare. Stent fracture is an uncommon complication associated with GDS; however, migration of the fractured distal segment can result in small bowel obstruction. Adverse effects of stent fractures in patients with mGOO have rarely been reported. We herein report two surgical cases of small bowel obstruction caused by the migration of fractured metal stent in patients with mGOO.

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“…Миг-рация (дислокация) стента, частота которой состав-ляет 7-15 % случаев, происходит в основном при ис-пользовании покрытых эндопротезов. Она может быть связана с неадекватным позиционированием стента (ранняя миграция) или развиться после хи-мио-и лучевой терапии (поздняя миграция) [16,[37][38][39][40][41]. Болевой синдром является одним из посто-янных признаков эндопротезирования, обусловлен процессом расправления стента и, как правило, про-ходит спонтанно.…”

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Colorectal stenting in cancer patients

Юричев¹,

Карасев²,

Vereshchak³

et al. 2018

Onkol. koloproktol.

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Background. Malignant colonic obstruction (MCO) it is one of the most common and severe complications of colon and rectal cancer. The mechanisms underlying MCO development include impairments in motor, secretory and resorptive functions of the intestine, disorders of water-electrolyte metabolism, endotoxicosis, and compartment syndrome. All of these conditions significantly reduce patient survival.Objective: to compare the outcomes of colonic stenting in patients with primary and secondary tumors and to assess the efficacy of surgical treatment.Material and methods. This retrospective study included 149 patients with MCO caused by both primary colon tumors and secondary compression or extra-colon tumors. All patients underwent X-ray guided colonic stenting in the N.N. Blokhin National Medical Research Center of Oncology between 2013 and 2017.Results. Primary technical success was achieved in 143 (96 %) patients, whereas overall technical success (including restenting) was achieved in 144 (96.6 %) patients. A total of 121 (84 %) patients demonstrated complete clinical success, while 23 (15.98 %) patients had partial clinical success. The efficacy of stenting was significantly higher in patients with primary colorectal cancer than in patients with secondary lesions of the colon (96.7 % vs. 27.3 %; p <0.0001).Conclusion. Stenting is a safe and effective method of comprehensive treatment for patients with colon cancer and signs of MCO. It expands the scope of palliative care for disseminated cancer. However, in patients with extra-organ compression and secondary lesions of the colon, this procedure remains largely ineffective.

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Fracture of a Colonic Self-expandable Metallic Stent in Malignant Colonic Obstruction

Cited by 5 publications

References 11 publications

Palliative treatment of intestinal obstruction in patients with gynecologic malignancies — single center experience

Palliative treatment of intestinal obstruction in patients with gynecologic malignancies — single center experience

Small Bowel Obstruction Caused by Migration of Fractured Metal Stent in Patients with Malignant Gastric Outlet Obstruction: A Report of Two Cases and Review of the Literature

Colorectal stenting in cancer patients

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