Interventional palliative strategies for malignant bowel obstruction

Baron, Todd H.

doi:10.1007/s11912-009-0041-3

Cited by 24 publications

(22 citation statements)

References 25 publications

(11 reference statements)

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“…Retrievable stents seem to be a good choice for patients with low rectal obstructions, since pain, incontinence, or tenesmus are potential severe problems that could be not reversible unless the stents are removed. 3 Currently several retrievable colonic stents are available in Europe and Asia Fig. 4, but none in the USA.…”

Section: Complications and Its Management 1) Minor Complicationsmentioning

confidence: 99%

“…In recent years dedicated colonic stents have been available with more flexible stents and longer delivery systems that have resulted in lesser incidence of device related complications, despite these recent advances the overall reintervention rate is still high and the ideal colorectal stent is yet to be developed. 3 Complications after colorectal stent placement are usually minor but severe life-threatening complications can developed any time after the procedure. The purpose of this article is to review the management of complications after colorectal stent placement from an interventional radiologist's perspective.…”

Section: Introductionmentioning

confidence: 99%

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Fluoroscopic Management of Complications after Colorectal Stent Placement

Lopera

Gregorio

2010

Gut Liver

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Colorectal self-expanding metal stents have been widely used as a bridge to surgery in patients with acute malignant colonic obstruction by allowing a single-stage operation, or as a definitive palliative procedure in patients with inoperable tumors. Colonic stents are placed under either fluoroscopic or combined endoscopic and fluoroscopic guidance, with similar technical-success and complication rates. Placement of colonic stents is a very safe procedure with a low procedure-related mortality rate, but serious complications can develop and reinterventions are not uncommon. Most of the complications can be treated by minimally invasive or conservative techniques, while surgical interventions are required for most patients with perforation. (Gut Liver 2010;4(Suppl. 1):S9-18)

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Section: Complications and Its Management 1) Minor Complicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fluoroscopic Management of Complications after Colorectal Stent Placement

Lopera

Gregorio

2010

Gut Liver

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“…In recent years dedicated colonic stents have been available with more flexible stents and longer delivery systems that have resulted in lesser incidence of device related complications; despite these recent advances, the overall re-intervention rate is still high and the ideal colorectal stent is yet to be developed. 16 Complications after colorectal stent placement are usually minor but severe life-threatening complications can develop any time after the procedure. 17 …”

Section: Complications After Colonic Stent Implantationmentioning

confidence: 99%

“…Minor complications related to colon stent placement such as mild to moderate rectal bleeding, transient anorectal pain, temporary incontinence, and fecal impaction are common in many reports (Table 1). [16][17][18][19][20][21][22][23][24][25][26] Late complications related to SEMS mainly include re-obstruction and migration of the stent, and rarely perforation. Migration incidence varies from 4% to 26% and is one of the more frequent complications observed at early follow-up.…”

Section: Frequency and Types Of Complicationsmentioning

confidence: 99%

Enteral stents: Complications and their management

Lopera

Gregorio

Laborda

et al. 2016

Int J Gastrointest Interv

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The treatment of malignant colonic and gastric outlet obstruction with self-expanding metallic stents (SEMS) is an established technique that can be performed by radiologic or a combination of radiologic and endoscopic guidance. The procedure is very effective to relieve the obstructive symptoms of advanced malignancies, with important clinical benefits and significant improvement in quality of life for the patients. Despite much advancement in the designs of SEMS, enteral stent placement is still associated with some significant early and late complications. Stent dysfunction mainly caused by tumor ingrowth/over growth, and stent migration when covered stent are used, are relatively common complications and many times require reinterventions.

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“…Colorectal stent placement is used for colonic decompression as a bridge to surgery in ACRO from malignant and benign etiologies and for palliation in patients with stage IV nonsurgical colorectal cancer [6]. Less common indications are relief of colonic obstruction due to extrinsic compression and benign disease under special circumstances [7].…”

Section: Introductionmentioning

confidence: 99%

Update on the Indications and Use of Colonic Stents

Bonin

Baron

2010

Curr Gastroenterol Rep

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Self-expandable metal stent (SEMS) placement is a minimally invasive option for achieving acute colonic decompression in obstructed colorectal cancer. Colorectal stenting offers nonoperative, immediate, and effective colon decompression and allows bowel preparation for an elective oncologic resection. Patients who benefit the most are highrisk surgical patients and candidates for laparoscopic resection with complete obstruction, because emergency surgery can be avoided in more than 90% of patients. Colonic stent placement also offers effective palliation of malignant colonic obstruction, although it carries risks of delayed complications. When performed by experienced endoscopists, the technical success rate is high with a low procedural complication rate. Despite concerns of tumor seeding following endoscopic colorectal stent placement, no difference exists in oncologic long-term survival between patients who undergo stent placement followed by elective resection and those undergoing emergency bowel resection. Colorectal stents have also been used in selected patients with benign colonic strictures. Uncovered metal stents should be avoided in these patients, and fully covered stents are associated with high risk of migration. Patients with benign colonic stricture with acute colonic obstruction who are at high risk for emergency surgery can gain temporary relief of obstruction after SEMS placement; the stent can be removed en bloc with the colon specimen at surgery. This article reviews the techniques and indications of SEMS placement for benign and malignant colorectal obstructions.

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Interventional palliative strategies for malignant bowel obstruction

Cited by 24 publications

References 25 publications

Fluoroscopic Management of Complications after Colorectal Stent Placement

Fluoroscopic Management of Complications after Colorectal Stent Placement

Enteral stents: Complications and their management

Update on the Indications and Use of Colonic Stents

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