Emergency Self- Expanding Metal Stenting for Malignant Colonic Obstruction: An Opportunity for Operation in a More Favorable Condition

Yıl 2017, Cilt: 8 Sayı: 2, 43 - 45, 01.04.2017

Cem Aygün Ersin Acet Tamer Karşıdağ

Öz

Introduction: Lower gastrointestinal system tumors represent a major source of morbidity and mortality. Bowel obstruction is a common complication in advanced colorectal cancer.Case Report: An 86-year-old male patient who was admitted to the emergency department with clinical complaints of ileus showed multiple air-fluid levels in an abdominal X-ray film. Computed tomography scans revealed an obstructing malignant mass in the sigmoid colon region. For immediate relief of obstruction, a self-expanding metal stent was placed by colonoscopy. Recovery from abdominal discomfort, flatulence, and vomiting was achieved shortly after stenting. With appropriate treatment and preoperative investigations, the patient was referred to undergo elective colectomy.Conclusion: In elderly and critically ill patients, endoscopic stenting may be an effective treatment for malignant large bowel obstruction. It may also be used as a bridge to surgery in more favorable conditions

Anahtar Kelimeler

Colorectal cancer, acute obstruction, stenting

Kaynakça

• Kim EJ, Kim YJ. Stents for colorectal obstruction: Past, present, and fu- ture. World J Gastroenterol 2016; 22: 842-52. [CrossRef ]
• Altuntas YE, Aksakal N, Oncel M. Stent application for obstructive left colon and upper rectal tumors: Current status. Turk J Colorectal Dis 2011; 21: 49-56. [CrossRef ]
• McLoughlin MT, Byrne MF. Endoscopic stenting: where are we now and where can we go? World J Gastroenterol 2008; 14: 3798-803. [CrossRef ]
• Law WL, Choi HK, Chu KW. Comparison of stenting with emergency sur- gery as palliative treatment for obstructing primary left-sided colorec- tal cancer. Br J Surg 2003; 90: 1429-33. [CrossRef ]
• Repici A, De Caro G, Luigiano C, Fabbri C, Pagano N, Preatoni P, et al. Wall Flex colonic stent placement for management of malignant colonic obstruction: a prospective study at two centers. Gastrointest Endosc 2008; 67: 77-84. [CrossRef ]
• Small AJ, Coelho-Prabhu N, Baron TH. Endoscopic placement of self- expandable metal stents for malignant colonic obstruction: long-term outcomes and complication factors. Gastrointest Endosc 2010; 71: 560- 72. [CrossRef ]
• Brehant O, Fuks D, Bartoli E, Yzet T, Verhaeghe P, Regimbeau JM. Elective (planned) colectomy in patients with colorectal obstruction after place- ment of a self-expanding metallic stent as a bridge to surgery: the results of a prospective study. Colorectal Dis 2009; 11: 178-83. [CrossRef]
• Van Hooft JE, van Halsema EE, Vanbiervliet G, Beets-Tan RG, DeWitt JM, Donnellan F, et al. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Gastrointest Endosc 2014; 80: 747-61. [CrossRef]
• Tilney HS, Lovegrove RE, Purkayastha S, Sains PS, Weston-Petrides GK, Darzi AW et al. Comparison of colonic stenting and open surgery for malignant large bowel obstruction. Surg Endosc 2007; 21: 225-33. [CrossRef ]
• Kim JH, Kwon KA, Lee JJ, Lee WS, Baek JH, Kim YJ, et al. Surgical failure af- ter colonic stenting as a bridge to surgery. World J Gastroenterol 2014; 20: 11826-34. [CrossRef ]