Malignant colorectal obstruction: treatment with a flexible covered stent.

Abstract

Flexible stents effectively relieved acute colonic obstruction secondary to malignant rectosigmoid neoplasm. Stent placement allowed patients to undergo single-stage surgery in most cases and provided palliative decompression in cases of inoperable or disseminated disease.

Comparison of uncovered stent with covered stent for treatment of malignant colorectal obstruction

“…8,9 Insertions of SEMS have become a popular procedure for preoperative decompression for palliative treatment in operable or inoperable malignant colorectal obstruction. [10][11][12][13] In our study, overall technical success and clinical efficacy rates were 97.5% (78/80) and 98.7% (77/78), respectively.…”

“…Cylindrical-formed covered stents were already known to frequently migrate. 11,13,[20][21][22] In the preliminary study at our hospital, cylindrical-formed covered stents were ineffective compared with uncovered stents because of frequent migration. So, recent covered stents were designed in a dumbbell shape with flange ends and to have a proximal uncovered portion for the prevention of migration.…”

“…Covered SEMS can prevent tumor ingrowth and have a relatively high incidence of stent migration. [10][11][12][13] Since Dohmoto 7 reported the first case of colonic stent placement, colonic stent placement has become a popular procedure. Most previous reports presented the success rates, durability, and complication of colorectal stent placement with uncovered stents.…”

Clinical Application of Self-Expandable Metallic Stent for Treatment of Colorectal Obstruction Caused by Extrinsic Invasive Tumors

“…Generally, covered stents may be superior in preventing tumor growth in patients who require long-term colonic decompression but inferior in preventing stent migration because they are less embedded into the walls of the lumen compared with uncovered stents. 21,[27][28][29][30][31][32] Comparing the success rate of stenting and complications according to stent type (covered vs. uncovered) in our study, the technical success rate was higher with uncovered stents. However, two covered stents that failed technically developed from immediate stent migration and technical problems unrelated to the stent type.…”

Safety and efficacy of metallic stents in the management of colorectal obstruction

“…10,16 In addition, the stent that was used in the patient with migration was covered, and covered stents have also been found to have higher migration rates due to the prevention of tissue ingrowth. 15,17,21,25 Nine of 10 patients who were treated with stents as a bridge to surgery received bowel preparation and underwent resection with primary anastomosis in 8 of 9 cases with good perioperative outcomes. One patient had a perforation of her tumor at the distal aspect of the stent that became clinically apparent 4 days after stent placement.…”