Cancer of the rectum—palliative endoscopic treatment

Rupp, K. D.; Dohmoto, M.; Meffert, R.; Holzgreve, Adrien; Hohlbach, G.

doi:10.1016/s0748-7983(95)95563-1

Cited by 44 publications

(16 citation statements)

References 2 publications

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“…Recently, encouraging results have been reported for the treatment of stenotic rectal carcinoma by endoscopic implantation of a prothesis [9,26,27]. In contrast to most endoscopic procedures, which require repeated treatment sessions after initial recanalization, rectal endoprothesis may prevent obstruction until death.…”

Section: Discussionmentioning

confidence: 99%

“…Technically, endoscopic implantation of a stent is a simple procedure that can be completed in 20-30 min. The distal extent of disease limits suitability for stenting because lesions less than 5 cm from the anal verge may be inappropriate for this procedure [27] because a minimum 1-to 1.5-cm overlap of stent on the lesion at each end is advised [18]. It seems reasonable to assume that to avoid any sensation of anorectal pain, the limit of a stent should be proximal to the dentate line.…”

Section: Discussionmentioning

confidence: 99%

“…Reports of more distally placed stent warn of the occurrence of chronic tenesmus. Complications of stent placement are common in many reports; in 50 cases [9,26,27], perforation occurred in 2 patients (4%), dislocation of the prothesis occurred in 8 cases (16%), 5 colostomies were performed, stent obstruction by tumor ingrowth occurred in 5 cases (10%) and was treated by laser therapy in 4 cases, and in 1 case a colostomy was performed. The disadvantage of stenting is that other tumor-related symptoms affecting the patient, such as bleeding or pain, may not be improved by this treatment.…”

Section: Discussionmentioning

confidence: 99%

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Palliation of carcinoma of the rectum using the urologic resectoscope

et al. 2003

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ETAR is a simple, minimally invasive, and economic method that should be part of palliative treatment for patients with rectal carcinoma. ETAR is a useful addition to the surgeon's armamentarium in the multidisciplinary approach of advanced rectal cancer together with laser destruction, stent implantation, and external beam radiotherapy. All these treatments must be evaluated not only in term of lumen patency or stoma rate, but also from the quality of life standpoint.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Palliation of carcinoma of the rectum using the urologic resectoscope

et al. 2003

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“…In the early 1990s, SEMS were first used for palliation of advanced malignancy (6), being later used to relieve acute obstruction, as a "bridge" to elective surgery (7). Although effectiveness of the use of colonic SEMS in a palliative or bridge-to-surgery indication is broadly recognized, some have questioned the safety of colonic stenting, particularly as it pertains to colonic perforation (8,9). Recent prospective randomized controlled trials have indicated that SEMS may be less successful at relieving obstruction than indicated from nonrandomized studies (10).…”

Section: Introductionmentioning

confidence: 99%

Outcome of endoscopic self-expandable metal stents in acute malignant colorectal obstruction at a tertiary center

Rodrigues‐Pinto¹,

Pereira²,

Lopes³

et al. 2015

Rev Esp Enferm Dig

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Background: Malignant colorectal obstruction (MCRO) by advanced colonic cancer occurs in 8-13% of colonic cancer patients. Emergent surgery carries a high mortality and morbidity risk. Endoscopic self-expanding metal stents (SEMS) may be used in acute MCRO.Aim: Evaluate clinical outcome of SEMS in acute MCRO and efficacy of SEMS placement considering fluoroscopy guidance.Methods: Retrospective study of patients with acute MCRO that placed SEMS in a 3 years period.Results: SEMS were placed in 47 patients, followed-up for a median time of 150 days. The intent of stenting was bridge to definitive surgery in 40% of the patients (n = 19) and palliation in the remaining 60% (n = 28). The location of the tumor did not influence the presence of lymph node involvement (p = 0.764) nor metastasis (p = 0.885). Mortality rate at year 1 was 61%. Survival was significantly higher in patients submitted later to combination therapy compared to chemotherapy, surgery or symptomatic treatment (p < 0.001). Fluoroscopy was used in 57% of the procedures. Clinical success was 79%. A second SEMS was needed during the procedure in 6% of the patients. Rate of early and late complications was 11% and 5%, respectively. Fluoroscopy guidance did not influence the occurrence of immediate (p = 0.385), early (p = 0.950) or late complications (p = 0.057). Thirty-three percent of patients underwent surgery at a later stage, with neo-adjuvant therapy in 18%.Conclusions: SEMS provide a relative safe and successful treatment in a palliative or bridge-to-surgery indication. No significant differences were found in SEMS placement success, early complications or late complications considering fluoroscopy guidance.

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“…They provide an altema tive to a colostomy for paffiating patients with obstructiondue to irresectable, locally recurrent colonic tumors [1][2][3][4], and they can relieve obstruction in patients with resectabletumors [5â€ "7]. The stents permit a planned, elective one-stage operation without the need for a tem poraiy stoma or for emergency surgery; more over,they may benefit elderly and frail patients with obstructing benign lesions [8].…”

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confidence: 99%