A dual-design expandable colorectal stent for malignant colorectal obstruction: results of a multicenter study

Song, Ho Young; Kim, J. H.; Shin, Ji Hoon; Kim, Ho-Chan; Yu, Chang Sik; Kang, Shin‐Geol; Yoon, Chang Jin; Lee, Ja Yil; Koo, Ja-Young; Lee, K.-H.; Kim, J.-K.; Kim, D. H.; Shin, Tae Beom; Jung, Ghap Joong; Han, Young-Min

doi:10.1055/s-2007-966270

Cited by 63 publications

(50 citation statements)

References 16 publications

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Section: Resultsmentioning

confidence: 99%

“…In contrast, the use of covered expandable metallic stents has been associated with stent migration (5, 7). To overcome the limitations associated with conventional bare and covered stents, a double coaxial self-expandable metallic stent (DCSEMS) has been developed to combine the strengths of bare and covered stents (7,8).The purpose of the present study was to report our experiences with fluoroscopic-guided placement of double stents in management of malignant colorectal obstruction as a bridge to surgery or palliative treatment. …”

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confidence: 99%

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Clinical effect of double coaxial self-expandable metallic stent in management of malignant colon obstruction

Won

Lee²,

Ku³

et al. 2015

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSEWe aimed to evaluate the clinical effectiveness and safety of double coaxial self-expandable metallic stent (DCSEMS) in management of malignant colonic obstruction as a bridge to surgery or palliation for inoperable patients. METHODSBetween April 2006 and December 2012, 49 patients (27 males and 22 females; median age, 68 years; age range, 38-91 years) were selected to receive decompressive therapy for malignant colonic obstruction by implanting a DCSEMS. Application of DCSEMS was attempted in 49 patients under fluoroscopic guidance. The obstruction was located in the transverse colon (n=2), descending colon (n=7), sigmoid colon (n=24), rectosigmoid junction (n=6), and the rectum (n=10). The intended use of DCSEMS was as a bridge to elective surgery in 23 patients and palliation in 26 patients. RESULTSClinical success, defined as >50% dilatation of the stent with subsequent symptomatic improvement, was achieved in 48 of 49 patients (98%). The stent was properly inserted in all patients. No immediate major procedure-related complications occurred. One patient in the bridge-to-surgery group had colon perforation three days after DCSEMS application. Four patients had late migrations of the double stent. CONCLUSION Application of DCSEMS is safe and effective in management of malignant colonic obstruction; it prevents stent migration and tumor ingrowth and lowers perforation rate during the stent application. F luoroscopic or endoscopic placement of either bare or covered expandable metallic stents was shown to be a safe, easy, and effective technique as a bridge to surgery and palliative treatment of colorectal cancer (1, 2). However, tumor ingrowth and stent migration have been reported as weaknesses in conventional single bare and covered stents, respectively (2-4). The use of bare stents has been hindered by progressive tumor ingrowth through the wire filaments of the bare stents and food residue or hard fecal impaction proximal to or at the level of the stent insertion site (5, 6). In contrast, the use of covered expandable metallic stents has been associated with stent migration (5, 7). To overcome the limitations associated with conventional bare and covered stents, a double coaxial self-expandable metallic stent (DCSEMS) has been developed to combine the strengths of bare and covered stents (7,8).The purpose of the present study was to report our experiences with fluoroscopic-guided placement of double stents in management of malignant colorectal obstruction as a bridge to surgery or palliative treatment. MethodsInformed consent was obtained from each patient and/or the legal guardian after the risks and benefits of the treatment were fully explained. Our Institutional Review Board approved this retrospective study. PatientsBetween April 2006 and December 2012, the images and clinical reports of 49 consecutive patients (27 males and 22 females; median age, 66 years; age range, 38-91 years) with malignant colorectal obstruction, who received decompressed therapy by DCSEMS implantation w...

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Clinical effect of double coaxial self-expandable metallic stent in management of malignant colon obstruction

Won

Lee²,

Ku³

et al. 2015

Diagn Interv Radiol

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“…long strictures, tortuous colonic segments) and colonic ischemia. [13][14][15] Laparoscopy is generally contraindicated in the presence of bowel obstruction since a distended bowel precludes a safe access to the abdominal cavity as well as manipulation of the bowel segments. Conversion of an emergent colonic resection into an elective one permits bowel preparation and may potentially avoid an ostomy.…”

Section: Discussionmentioning

confidence: 99%

The role of colorectal stent placement in the management of acute malignant obstruction

Yanar¹,

Özçınar²,

Yanar³

et al. 2014

Ulus Travma Acil Cerrahi Derg

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“…The delivery system currently is 12 Fr and supplied for over-the-wire placement. Initial results showed a high perforation rate of over 10% in the colon, 22 which seems to have improved with a smaller delivery system. …”

Section: Modular Stentsmentioning

confidence: 99%

“…Migration rates are improved to < 3% for modular stents. [21][22][23] Results regarding double covered stents are less clear. Limited data has only been published to date with a migration rate of 10% and 20% in the small 8 and large 27 bowel respectively.…”

Section: Stent Failure Stent Migrationmentioning

confidence: 99%

Enteral stent construction: Current principles

Laasch

Edwards

Song

2016

Int J Gastrointest Interv

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A B S T R A C TThe insertion of self-expanding stents into malignant strictures of the small and large bowel has become a routine procedure around the world. However, stent development has happened very much on a "trial & error" approach, based mostly on bright ideas of enthusiastic individuals or marketing decisions by the manufacturer. A large variety of stents are commercially available, covered to a variable degree by a membrane to reduce tissue ingrowth. However, in vitro characteristics and in vivo behavior vary significantly between stents and few operators are aware of the differences. While the ideal stent still remains to be defined, it is important that interventionists understand the variations, in order to make the best possible choice for the individual patient. This article illustrates current principles of stent construction.

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A dual-design expandable colorectal stent for malignant colorectal obstruction: results of a multicenter study

Abstract: The dual stent with a 4.5-mm stent delivery system is easy to insert, safe, and reasonably effective for the palliative treatment of malignant colorectal obstruction. However, a great deal of care is needed in its deployment because of the high rate of perforation.

Cited by 63 publications

References 16 publications

Clinical effect of double coaxial self-expandable metallic stent in management of malignant colon obstruction

Clinical effect of double coaxial self-expandable metallic stent in management of malignant colon obstruction

The role of colorectal stent placement in the management of acute malignant obstruction

Enteral stent construction: Current principles

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