Clinical Application of Self-Expandable Metallic Stent for Treatment of Colorectal Obstruction Caused by Extrinsic Invasive Tumors

Shin, Sung Jae; Kim, Tae Il; Kim, Jae Hak; Lee, Yong Chan; Song, Si Young

doi:10.1007/s10350-008-9207-6

Cited by 81 publications

(14 citation statements)

References 29 publications

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“…In cases with Schnitzler's metastasis, extrinsic invasion into the rectum leads to obstruction of the lumen and often occurs at more than one location in cases of carcinomatosis. However, a high rate of clinical success of SEMS placement for extrinsic lesions was also reported [10]. In the present case, even though carcinomatosis was present, the obstruction was limited to the rectum.…”

Section: Discussionmentioning

confidence: 52%

Successful Self-Expandable Metallic Stent Placement for a Case of Distal Rectal Stenosis due to Gastric Cancer Metastasis

Okugawa

Oshima

Ikeo

et al. 2013

Case Rep Gastroenterol

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A 47-year-old woman was diagnosed as having advanced gastric cancer with malignant ascites. Despite chemotherapy, recurrent peritoneal dissemination was seen 1.5 years after operation. A computed tomography scan revealed rectal stenosis due to Schnitzler's metastasis. When the distance from the distal end of the obstruction to the anal verge is less than 5 cm, stent replacement has been said to be contraindicated due to the development of anal pain and foreign body sensation. Although the distance from the distal end of the obstruction to the anal verge was 4 cm in this case, a WallFlex™ colonic stent could be placed. She stayed home, and luminal patency remained until she died 270 days after stent insertion. This report demonstrates that rectal obstruction located less than 5 cm from the anal verge due to Schnitzler's metastasis could be treated by stenting without any symptomatic or technical complications.

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Section: Discussionmentioning

confidence: 52%

Successful Self-Expandable Metallic Stent Placement for a Case of Distal Rectal Stenosis due to Gastric Cancer Metastasis

Okugawa

Oshima

Ikeo

et al. 2013

Case Rep Gastroenterol

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“…The outcome of stenting for managing colorectal obstruction from extrinsic invasive tumors has been previously investigated, although its safety and efficiency are controversial (11,18). These patients often present with a complex stricture of the lumen, potentially at more than one locations, with complex adhesions, which result in bowel immobilization and altogether may contribute to the low success and high complication rate of SEMS placement.…”

Section: Discussionmentioning

confidence: 99%

Observational study of colonoscopy techniques used for acute colorectal obstruction: A single-center experience

Chen

et al. 2017

Molecular and Clinical Oncology

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The prevalence of acute colorectal obstruction at the hospital setting is high. There is need for improvement in the quality of colonoscopy for relieving obstruction. A retrospective, uncontrolled, open-label study was conducted, with the aim of documenting the causes of acute colorectal obstruction and the quality of colonoscopy practice in managing obstruction at a university hospital in China. A total of 61 adult patients with acute colorectal obstruction treated with urgent colonoscopy between February, 2011 and January, 2016 were identified at the Endoscopic Unit of Tongji Hospital (Wuhan, China). The technique success rate was the primary outcome. The etiology was mainly related to malignant diseases, including colorectal cancer in 53 patients (86.9%) and advanced peritoneal serous carcinoma leading to extrinsic colonic compression in 1 patient (1.6%). Benign causes of obstruction included foreign bodies in 3 patients (4.9%) and fecal impaction in 2 patients (3.3%); furthermore, anastomotic strictures were found in 2 patients (3.3%). The technique success rate was 98.4% (60/61). All colorectal cancer patients who underwent urgent colonoscopy were admitted to the Department of Surgery for placement of a self-expanding metallic stent; 1 patient who had an extracolonic malignancy underwent placement of a transanal colonoscopic decompression tube as palliative therapy and 2 patients with anastomotic strictures underwent endoscopic balloon dilation. Furthermore, colonoscopy was used for extracting the foreign body, as well as removing fecal stones in all the patients. In conclusion, urgent colonoscopy as a minimal invasive approach is associated with certain advantages for diagnosing and managing acute colorectal obstruction. Furthermore, experienced operators achieved a better outcome when managing colorectal obstruction.

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“…When emergency surgery is conducted for these patients, a 15 to 20% death rate and about a 50% complication rate are reported [22]. Since stent insertion was introduced in 1991 for treating colorectal cancer, it has been reported to be an effective non-surgical treatment that can relieve the symptoms of acute obstruction caused by the tumor [23-25]. In spite of the very common complications of stent insertion, such as migration of the stent, colon perforation and obstruction, the 6-month clinical success rate has been reported at 81% or more [24], and the median survival rate calculated through the present study was 5 months.…”

Section: Discussionmentioning

confidence: 99%

Multivariate Analysis of the Survival Rate for Treatment Modalities in Incurable Stage IV Colorectal Cancer

Kim

Lee

2012

J Korean Soc Coloproctol

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PurposeThe aim of this study was to compare survival in patients that underwent palliative resection treatment versus non-resection for incurable colorectal cancer (ICRC).MethodsThe case records of 201 patients with ICRC between January 2000 and December 2009 were reviewed. Demographics, American Society of Anesthesiologists (ASA) score, carcinoembryonic antigen (CEA) level, the location of the colon cancer, histology, metastasis, treatment options and median survival were analyzed retrospectively. We divided the patients into four groups according to the treatment modalities: resection alone, resection with post-operative chemotherapy, non-resection treatment by chemotherapy alone, and stent or bypass. Median survival times were compared according to each treatment option, and the survival rates were analyzed.Results105 patients underwent palliative resection whereas 96 were treated with non-resection modalities. A palliative resection was performed in 44 cases for resection alone and in 61 cases for resection with post-operative chemotherapy. In patients treated with non-resection of the primary tumor, chemotherapy alone was done in 65 cases and stent or bypass in 31 cases. Multivariate analysis showed a median survival of 14 months in patients with palliative resections with post-operative chemotherapy, which was significantly higher than those for chemotherapy alone (8 months), primary tumor resection alone (5 months), and stent or bypass (5 months). Gender, age, ASA score, CEA level, the location of colon cancer, histology and the presence of multiple metastases were not independent factors in association with the median survival rate.ConclusionIn the treatment of ICRC, palliative resection followed by post-operative chemotherapy shows the most favorable median survival compared to other treatment options.

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Clinical Application of Self-Expandable Metallic Stent for Treatment of Colorectal Obstruction Caused by Extrinsic Invasive Tumors

Cited by 81 publications

References 29 publications

Successful Self-Expandable Metallic Stent Placement for a Case of Distal Rectal Stenosis due to Gastric Cancer Metastasis

Successful Self-Expandable Metallic Stent Placement for a Case of Distal Rectal Stenosis due to Gastric Cancer Metastasis

Observational study of colonoscopy techniques used for acute colorectal obstruction: A single-center experience

Multivariate Analysis of the Survival Rate for Treatment Modalities in Incurable Stage IV Colorectal Cancer

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