Ten-year Retrospective Study of Treatment of Malignant Colonic Obstructions with Self-expandable Stents

Gregorio, Miguel Ángel De; Laborda, Alicia; Tejero, Eloy; Miguelena, J. M.; Carnevale, Francisco César; Blas, Ignacio de; Giménez, Mariano Eduardo; Maynar, Manuel; D’Agostino, Horacio

doi:10.1016/j.jvir.2011.02.002

Cited by 33 publications

(23 citation statements)

References 37 publications

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“…Comparable success rates of combined endoscopic and fluoroscopic guidance and purely fluoroscopy have been demonstrated by retrospective studies. [18][19][20] However there is a trend towards better success rates with the combined technique hence ESGE recommend colonic SEMS placement with combined endoscopy and fluoroscopy. 15 ESGE discourage dilatation of malignant colonic stricture, either before or after SEMS placement.…”

Section: General Considerations and Techniquementioning

confidence: 99%

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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Section: General Considerations and Techniquementioning

confidence: 99%

Colonic cancer: The current role of stent insertion

Newton

Hill

2017

Int J Gastrointest Interv

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“…10 Currently an effective, safe and feasible alternative for these patients with malignant colorectal obstruction is decompression by SEMS. [11][12][13][14] The normalization of intestinal transit by stenting via fluoroscopic or endoscopic facilitates elective surgery, decreases surgical time and avoids temporary or permanent stoma.…”

Section: Complications After Colonic Stent Implantationmentioning

confidence: 99%

“…13,14 A high incidence of perforations (10%) associated with balloon dilation was reported in review with 568 patients. 21 Stent type Certain stents maybe too rigid for the normal curvatures of the colon.…”

Section: Balloon Dilatationmentioning

confidence: 99%

“…Migration can lead to recurrence of the obstructive symptoms, but in many cases the improvement of the stricture after chemoradiation leads to the migration and additional intervention may be not required. 14,19 In most instances, the stent migrates distally and sometimes the stent passes out through the anus (Fig. 4).…”

Section: Migrationmentioning

confidence: 99%

“…Stent obstructions occur from 48 hours to 480 days after placement and treatments included laser therapies to ablate obstructing tissue, restenting, surgery, and colonic irrigation. 14,17 In most cases restenting provides a definitive solution. Covered stents have a lower incidence of tumor ingrowth, but technical difficulties during deployment due to larger delivery systems, and a higher incidence of stent migration, have precluded a wider acceptance of this type of stents in the colon.…”

Section: Reobstructionmentioning

confidence: 99%

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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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