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Stent Use in Emergency Treatment of Malignant Colonic Obstruction

Yıl 2019, Cilt: 5 Sayı: 3, 189 - 193, 01.07.2019
https://doi.org/10.5455/umj.20190510021841

Öz

Background: In previous studies, the outcome of stent use in malignant colonic obstruction patients widely varies. We aim to present the outcome of our patients who have undergone colonic stenting in malignant colonic obstruction as a bridge or conservative therapy in line with the literature. Materials and Method: We have retrospectively reviewed patient records in surgical endoscopy clinic of our hospital. The subjects were patients who had a diagnosis of colon malignancy between 2012-2018 and had undergone a self-expandable stent. Stenting was done as a bridge to surgery in resectable colorectal tumors or for palliation in colonic obstructions due to inoperable colorectal malign disease. Clinical success was defined as resolution of obstructive symptoms and immediate decompression of the bowels proven by the passage of stool and gas in 24 hr. Results: Twenty patients were included in the study. 14 70% patients were male, and 6 30% female, mean age was 61.4±22.6 years. Right colon 1 5% , hepatic flexure 5 25% , splenic flexure 1 5% , sigmoid colon 7 35% , recto-sigmoid 2 10% , upper rectum 4 20% stenting was performed in terms of location. In 11 of the patients 55% , the tumor was considered resectable. After the emergency condition of the patients was improved by stenting, they were ready for elective curative surgery. In nine 45% patients, the tumor was unresectable. In these patients, stenting was ensued by oncologic follow-up. Stent migration after the procedure 3 15% , stent remaining at distal during the procedure 2 10% , re-obstruction after the procedure due to tumor invasion 2 10% , inadequate expansion of the stent 1 5% and perforation 1 5% were observed in patients. Conclusion: Stenting as a bridge or conservative therapy in malignant colonic obstruction by skilled surgeon increases success rates of one-stage operation significantly and increases the quality of life by decreasing the rates of a permanent stoma and wound infections.

Kaynakça

  • 1. Landis, S.H., et al., Cancer statistics, 1998. CA: a cancer journal for clinicians, 1998. 48(1):6-29
  • 2. Ribeiro, I.B., et al., Acute abdominal obstruction: Colon stent or emergency surgery? An evidence-based review. World journal of gastrointestinal endoscopy, 2019. 11(3):193 3. Mauro, M.A., R.E. Koehler, and T.H. Baron, Advances in gastrointestinal intervention: treatment of gastroduodenal and colorectal obstructions with metallic stents. Radiology, 2000. 215(3):659-669 4. Fung BM, Sweetser S, Wong Kee Song LM, Tabibian JH. Foreign object ingestion and esophageal food impaction: An update and review on endoscopic management. World J Gastrointest Endosc. 2019;11(3):174–192
  • 5. Bhardwaj, R. and M. Parker, Palliative therapy of colorectal carcinoma: stent or surgery? Colorectal Disease, 2003. 5(5): 518-521
  • 6. Tan, C., B. Dasari, and K. Gardiner, Systematic review and meta‐analysis of randomized clinical trials of self‐expanding metallic stents as a bridge to surgery versus emergency surgery for malignant left‐sided large bowel obstruction. British Journal of Surgery, 2012. 99(4): 469-476
  • 7. Gianotti, L., et al., A prospective evaluation of short-term and long-term results from colonic stenting for palliation or as a bridge to elective operation versus immediate surgery for large-bowel obstruction. Surgical endoscopy, 2013. 27(3): 832-842
  • 8. Ho, K.-S., et al., Endoscopic stenting and elective surgery versus emergency surgery for left-sided malignant colonic obstruction: a prospective randomized trial. International journal of colorectal disease, 2012. 27(3):355-362
  • 9. Arezzo, A., et al., Colonic stenting as a bridge to surgery versus emergency surgery for malignant colonic obstruction: results of a multicentre randomised controlled trial (ESCO trial). Surgical endoscopy, 2017. 31(8):3297-3305
  • 10. White, S.I., et al., Management of malignant left‐sided large bowel obstruction: a comparison between colonic stents and surgery. ANZ journal of surgery, 2011. 81(4):257-260
  • 11. Blake, P., et al., Large bowel obstruction due to colorectal carcinoma can be safely treated by colonic stent insertion– case series from a UK district general hospital. Colorectal Disease, 2012. 14(12):1489-1492
  • 12. Geraghty, J., et al., Management of large bowel obstruction with self‐expanding metal stents. A multicentre retrospective study of factors determining outcome. Colorectal Disease, 2014. 16(6):476-483
  • 13. Yoon, J.Y., et al., Clinical outcomes and risk factors for technical and clinical failures of self-expandable metal stent insertion for malignant colorectal obstruction. Gastro intestinal endoscopy, 2011. 74(4):858-868
  • 14. Lee, J.G., et al., Angular positioning of stent increases bowel perforation after self-expandable metal stent placement for malignant colorectal obstruction. Clinical endoscopy, 2013. 46(4):384
  • 15. Lujan, H.J., et al., Self-expanding metallic stents for palliation and as a bridge to minimally invasive surgery in colorectal obstruction. Journal of the Society of Laparoendoscopic Surgeons, 2013. 17(2):204
  • 16. Sebastian, S., et al., Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction.The American journal of gastroenterology, 2004. 99(10):2051
  • 17. Ng, K.C., et al., Self-expanding metallic stent as a bridge to surgery versus emergency resection for obstructing leftsided colorectal cancer: a case-matched study. Journal of Gastrointestinal Surgery, 2006. 10(6):798-803
  • 18. Van Hooft, J.E., et al., Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy Clinical Guideline. Gastrointestinal Endoscopy, 2014. 80(5):747-761
  • 19. De Ceglie, A., et al., A meta-analysis of endoscopic stenting as bridge to surgery versus emergency surgery for left-sided colorectal cancer obstruction. Critical reviews in oncology/ hematology, 2013. 88(2):387-403
  • 20. Van den Berg, M., et al., Bridge‐to‐surgery stent placement versus emergency surgery for acute malignant colonic obstruction. British Journal of Surgery, 2014. 101(7):867-873
  • 21. Boyle, D.J., et al., Predictive factors for successful colonic stenting in acute large-bowel obstruction: a 15-year cohort analysis. Diseases of Colon & Rectum, 2015. 58(3):358-362
Yıl 2019, Cilt: 5 Sayı: 3, 189 - 193, 01.07.2019
https://doi.org/10.5455/umj.20190510021841

Öz

Kaynakça

  • 1. Landis, S.H., et al., Cancer statistics, 1998. CA: a cancer journal for clinicians, 1998. 48(1):6-29
  • 2. Ribeiro, I.B., et al., Acute abdominal obstruction: Colon stent or emergency surgery? An evidence-based review. World journal of gastrointestinal endoscopy, 2019. 11(3):193 3. Mauro, M.A., R.E. Koehler, and T.H. Baron, Advances in gastrointestinal intervention: treatment of gastroduodenal and colorectal obstructions with metallic stents. Radiology, 2000. 215(3):659-669 4. Fung BM, Sweetser S, Wong Kee Song LM, Tabibian JH. Foreign object ingestion and esophageal food impaction: An update and review on endoscopic management. World J Gastrointest Endosc. 2019;11(3):174–192
  • 5. Bhardwaj, R. and M. Parker, Palliative therapy of colorectal carcinoma: stent or surgery? Colorectal Disease, 2003. 5(5): 518-521
  • 6. Tan, C., B. Dasari, and K. Gardiner, Systematic review and meta‐analysis of randomized clinical trials of self‐expanding metallic stents as a bridge to surgery versus emergency surgery for malignant left‐sided large bowel obstruction. British Journal of Surgery, 2012. 99(4): 469-476
  • 7. Gianotti, L., et al., A prospective evaluation of short-term and long-term results from colonic stenting for palliation or as a bridge to elective operation versus immediate surgery for large-bowel obstruction. Surgical endoscopy, 2013. 27(3): 832-842
  • 8. Ho, K.-S., et al., Endoscopic stenting and elective surgery versus emergency surgery for left-sided malignant colonic obstruction: a prospective randomized trial. International journal of colorectal disease, 2012. 27(3):355-362
  • 9. Arezzo, A., et al., Colonic stenting as a bridge to surgery versus emergency surgery for malignant colonic obstruction: results of a multicentre randomised controlled trial (ESCO trial). Surgical endoscopy, 2017. 31(8):3297-3305
  • 10. White, S.I., et al., Management of malignant left‐sided large bowel obstruction: a comparison between colonic stents and surgery. ANZ journal of surgery, 2011. 81(4):257-260
  • 11. Blake, P., et al., Large bowel obstruction due to colorectal carcinoma can be safely treated by colonic stent insertion– case series from a UK district general hospital. Colorectal Disease, 2012. 14(12):1489-1492
  • 12. Geraghty, J., et al., Management of large bowel obstruction with self‐expanding metal stents. A multicentre retrospective study of factors determining outcome. Colorectal Disease, 2014. 16(6):476-483
  • 13. Yoon, J.Y., et al., Clinical outcomes and risk factors for technical and clinical failures of self-expandable metal stent insertion for malignant colorectal obstruction. Gastro intestinal endoscopy, 2011. 74(4):858-868
  • 14. Lee, J.G., et al., Angular positioning of stent increases bowel perforation after self-expandable metal stent placement for malignant colorectal obstruction. Clinical endoscopy, 2013. 46(4):384
  • 15. Lujan, H.J., et al., Self-expanding metallic stents for palliation and as a bridge to minimally invasive surgery in colorectal obstruction. Journal of the Society of Laparoendoscopic Surgeons, 2013. 17(2):204
  • 16. Sebastian, S., et al., Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction.The American journal of gastroenterology, 2004. 99(10):2051
  • 17. Ng, K.C., et al., Self-expanding metallic stent as a bridge to surgery versus emergency resection for obstructing leftsided colorectal cancer: a case-matched study. Journal of Gastrointestinal Surgery, 2006. 10(6):798-803
  • 18. Van Hooft, J.E., et al., Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy Clinical Guideline. Gastrointestinal Endoscopy, 2014. 80(5):747-761
  • 19. De Ceglie, A., et al., A meta-analysis of endoscopic stenting as bridge to surgery versus emergency surgery for left-sided colorectal cancer obstruction. Critical reviews in oncology/ hematology, 2013. 88(2):387-403
  • 20. Van den Berg, M., et al., Bridge‐to‐surgery stent placement versus emergency surgery for acute malignant colonic obstruction. British Journal of Surgery, 2014. 101(7):867-873
  • 21. Boyle, D.J., et al., Predictive factors for successful colonic stenting in acute large-bowel obstruction: a 15-year cohort analysis. Diseases of Colon & Rectum, 2015. 58(3):358-362
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Research Article
Yazarlar

Yahya Celik Bu kişi benim

Ozan Andac Erbil Bu kişi benim

Yayımlanma Tarihi 1 Temmuz 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 5 Sayı: 3

Kaynak Göster

Vancouver Celik Y, Erbil OA. Stent Use in Emergency Treatment of Malignant Colonic Obstruction. ULUTAS MED J. 2019;5(3):189-93.