Colonic Stent Placement Facilitated by Percutaneous Cecostomy and Antegrade Enema

Velling, Thomas E.; Hall, Lee D.; Brennan, Frank J.

doi:10.2214/ajr.175.1.1750119

Cited by 14 publications

(6 citation statements)

References 10 publications

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“…(b) Choice of the procedure : Among the studies, 17 included an explanation regarding the rationale of selecting the method of choice for the placement of PEC. The stated reasons are limited colonoscopy, 14 dolichocolon, 36 specific indication to deliver a therapeutic agent (fecal microbiota transplantation), 23 ineligibility for surgery, 19 , 20 , 25 – 27 , 31 , 33 , 39 multiple prior colonic decompressions and the subsequent choice to proceed with colonoscopy and PEC, 18 , 21 , 24 , 26 , 31 interposition between the stomach and transverse colon, 20 , 37 inability to decompress the colon by colonoscopy and subsequent choice to proceed with fluoroscopy 29 or abdominal CT scan with fluoroscopic PEC insertion, 25 patient refusal to undergo surgical cecostomy, 27 and a new diagnosis of colon cancer. 39 …”

Section: Resultsmentioning

confidence: 99%

“…(e) Procedural anesthesia : Twelve studies included procedures that were performed under conscious sedation. 15 , 18 , 20 , 27 – 29 , 31 – 33 , 35 , 37 Six studies used general anesthesia. 14 , 21 , 23 , 25 , 36 , 38 General anesthesia was used only in three studies without mentioning the agents used or its relation to the type of procedure.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Therapeutic utility of percutaneous cecostomy in adults: an updated systematic review

Khayyat

2022

Clin Med Insights Gastroenterol

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Objective: Percutaneous cecostomy is a minimally invasive procedure that provides access to the colon for therapeutic interventions. This review aimed to update and summarize the existing information on the use and application of percutaneous endoscopic cecostomy in the field of therapeutic gastroenterology. Data Sources: A systematic review of the literature was performed without any restrictions on the year of publication from the date of inception in 1986 to January 2021. Methods: The review was performed using the medical subject heading keywords in the following search engines: MEDLINE, EMBASE, Cochrane, and Google Scholar. Results: A total of 29 articles were subjected to final data extraction. The review included a total of 174 patients who underwent percutaneous cecostomy. Most of the included studies were conducted in the United States ( n = 14). The most common comorbidity was cancer ( n = 10) and the major indication for performing percutaneous cecostomy was colonic pseudo-obstruction or Ogilvie’s syndrome ( n = 15). The main technique for performing percutaneous cecostomy was endoscopy (17 studies), followed by fluoroscopy- (five studies), computed-tomography- (three studies), laparoscopy- (two studies), and ultrasound- (one study) guided procedures. The procedure was technically successful in 153 (88%) cases. The total cumulative rates of major and minor complications were 47.5%. These complications included tube malfunction, local wound site infections, and bleeding and rare complications of peritonitis and death. Conclusion: Percutaneous cecostomy is a safe and effective option for managing acute colonic pseudo-obstruction. It leads to durable symptom relief with low to minimal risk.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Therapeutic utility of percutaneous cecostomy in adults: an updated systematic review

Khayyat

2022

Clin Med Insights Gastroenterol

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“…In palliative cases, when it is not possible to access the colonic tumor from a retrograde approach, antegrade placement of colonic stents through a cecostomy or colostomy is a feasible alternative (13).…”

Section: Techniquesmentioning

confidence: 99%

Metal stents for malignant colorectal obstruction

Repici

Pagano

Hervoso

et al. 2006

Minimally Invasive Therapy & Allied Technologies

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Malignant obstruction of the colon occurs in 7-25% of patients with colorectal cancer. As emergency laparotomy is reported to have relatively high morbidity and mortality rate, there is a need for alternative procedures with reduced complication rates. Over the last decade colorectal stenting has been reported as an alternative endoscopic method to relieve acute colonic obstruction. With the availability of more sophisticated stents and stent delivery systems, this approach has been used as a palliative method and as a pre-operative bridge to facilitate one-stage surgical resection of primary colonic tumors. Technical and clinical successes have been reported in 80-100% of treated patients. Distal lesions are more common and theoretically easier to stent although lesions within the ascending colon have been successfully managed. Minor complications include transient anorectal pain, tenesmus and rectal bleeding. However, stent migration and colonic perforation are also well recognized. Despite the fact that no randomized controlled studies have yet been performed, literature data show that colonic stenting is a safe and effective procedure and can reduce costs, avoiding the need for colostomy and improving the quality of life of patients with advanced disease.

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“…In palliative cases when it is not possible to access the colonic tumor from a retrograde approach, antegrade placement of colonic stents through a cecostomy or colostomy is a feasible alternative. 26 In two nonsurgical patients with obstruction in the transverse colon and marked tortuosity of the colon, we deployed stents through a percutaneous colostomy and cecostomy, respectively 27 (Fig. 10).…”

Section: Stent Designmentioning

confidence: 99%

Colon Stenting: A Review

Gregorio

Mainar

Rodriguez

et al. 2004

Semin intervent Radiol

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Up to 85% of patients who present with colonic obstruction have a colorectal cancer. Between 7% and 29% of these patients present with total or partial intestinal obstruction. Only 20% of these patients presenting with acute colonic obstruction due to malignancy survive 5 years. Emergent surgical intervention in patients with colonic obstruction is associated with significant morbidity and mortality rates. Only 40% of patients with obstructive carcinoma of the left colon can be treated with surgical resection without the need for a colostomy. The use of a temporary or permanent colostomy has a significant impact on quality of life. The decompressive effect seen with colonic stenting is a durable, simple, and effective palliative treatment of patients with advanced disease. Stent deployment provides an effective solution to acute colonic obstruction and allows surgical treatment of the patient in an elective and more favorable condition. In addition, colonic stenting reduces costs and avoids the need for a colostomy.

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Colonic Stent Placement Facilitated by Percutaneous Cecostomy and Antegrade Enema

Cited by 14 publications

References 10 publications

Therapeutic utility of percutaneous cecostomy in adults: an updated systematic review

Therapeutic utility of percutaneous cecostomy in adults: an updated systematic review

Metal stents for malignant colorectal obstruction

Colon Stenting: A Review

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