Endoscopic stent in malignant colonic obstruction: the risk of tumor seeding

Abstract

Introduction Malignant colonic occlusion is traditionally considered a surgical emergency. With the development of endoscopic techniques, metallic stents have emerged to ensure the colonic patency in nonsurgical candidates and, more recently, as a temporary measure until elective resection surgery is possible. Materials and methods The research was conducted in PubMed and collected a total of 46 articles, including cross-references. Results Ideally, intestinal occlusion should be resolved through tumor's primary resection with direct anastomosis. To avoid dehiscence of the anastomosis, tumor's resection may be performed with Hartmann's procedure. Metal stents are an alternative to emergency surgery and show excellent results in reliving colonic obstruction. However, they may have serious complications related to colonic perforation, migration and tumor dissemination. Discussion and conclusion Observational studies and clinical trials show discrepant results. Metal stents are increasingly accepted in palliative care but are not yet recommended as a bridge to curative surgery. Treatment should be individualized, according to surgical risk and the probability of endoscopic complications.

Magnetic Compression of Tumor Spheroids Increases Cell Proliferation In Vitro and Cancer Progression In Vivo

“…Due to an original set of magnetic methodologies mediated by the internalization of iron oxide nanoparticles, the harmful role of physical factors in cancer progression was evidenced in vitro and in vivo. The overall results are consistent with the ones observed in mice treated with SEMSs, where a decrease in the mouse survival time was observed after tumor compression thus questioning the long-term benefits and the consequences of such a surgical act [ 63 , 64 ]. Herein, magnetic anisotropic tumor pre-compression triggers an increase in vitro of both cancer cell proliferation and expression of matrix metalloproteinases, and it induces in vivo amplified malignancy after injection.…”