Colonic stenting as bridge to surgery versus emergency surgery for management of acute left-sided malignant colonic obstruction: a multicenter randomized trial (Stent-in 2 study)

Hooft, Jeanin E. van; Bemelman, Willem A.; Breumelhof, R.; Siersema, Peter D.; Kruyt, Philip M.; Linde, K; Veenendaal, R. A.; Verhulst, Marie Louise; Marinelli, A.; Gerritsen, Josephus J.; Berkel, Anne Marie Van; Timmer, Robin; Grubben, M.J.A.L.; Scholten, Pieter; Geraedts, A. A. M.; Oldenburg, Bas; Sprangers, Mirjam A. G.; Bossuyt, Patrick M.; Fockens, Paul

doi:10.1186/1471-2482-7-12

Cited by 42 publications

(41 citation statements)

References 22 publications

(23 reference statements)

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“…3 Forest plot of the meta-analysis of long-term survival adverse events, and the sample size of the current analysis might be too small to detect the difference. This issue requires further large-size prospective randomized studies such as the Stent-in 2 study in process [39].…”

Section: Discussionmentioning

confidence: 98%

Self-expanding metallic stent as a bridge to surgery versus emergency surgery for obstructive colorectal cancer: a meta-analysis

et al. 2011

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Section: Discussionmentioning

confidence: 98%

Self-expanding metallic stent as a bridge to surgery versus emergency surgery for obstructive colorectal cancer: a meta-analysis

et al. 2011

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“…While longterm data are not yet available, there are currently two large randomized multicentre trials evaluating the safety of stenting as a bridge to surgery, i.e. the Stent-in-2 study [46] and the ESCO (Enteral Stent for Colonic Obstruction) study.…”

Section: Discussionmentioning

confidence: 99%

Treatment of left-sided colonic emergencies: a comparison of US, UK and Australian surgeons

et al. 2009

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“…The results of further randomized controlled trials, such as the Dutch Stentin 2 study [60] , are awaited to bolster the existing evidence. Covered stents and pre-deployment dilatation appear to increase the complication rate.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic stenting-Where are we now and where can we go?

Mcloughlin¹,

Byrne²

2008

WJG

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Self expanding metal stents (SEMS) play an important role in the management of malignant obstructing lesions in the gastrointestinal tract. Traditionally, they have been used for palliation in malignant gastric outlet and colonic obstruction and esophageal malignancy. The development of the polyflex stent, which is a removable self expanding plastic stent, allows temporary stent insertion for benign esophageal d i s e a s e a n d p o s s i b l y fo r p a t i e n t s u n d e r g o i n g neoadjuvant chemotherapy prior to esophagectomy. Potential complications of SEMS insertion include perforation, tumour overgrowth or ingrowth, and stent migration. Newer stents are being developed with the aim of increasing technical and clinical success rates, while reducing complication rates. Other areas of development include biodegradable stents for benign disease and radioactive or drug-eluting stents for malignant disease. It is hoped that, in the future, newer stents will improve our management of these difficult conditions and, possibly, provide prognostic as well as symptomatic benefit in the setting of malignant obstruction.© 2008 The WJG Press. All rights reserved. [9] and improvements in quality of life, dysphagia, and eating scales [10] for brachytherapy. It has been suggested that, as stent re-intervention is likely to be increased for those who live longer, SEMS should be considered for those with a poorer prognosis, and chemo/radiotherapy, with temporary stent placement, for those with a longer life expectancy [2] . A Korean group inserted a removable nitinol stent in 47 patients who had concur rent radiotherapy and extracted the stent in 24 patients after 4 wk, leaving the stent in place in the remaining patients [11] . The complication and re-intervention rates were significantly lower in the group in which the stent was extracted, while the dysphagia-progression-free and overall survival rates were significantly longer. No randomized trials have yet been conducted with the Polyflex stent, which is the only removable stent licensed in the USA in this setting. Further randomized trials of SEMS in combination with other treatment modalities would help determine the optimal management strategy in terms of symptom control and overall survival. Drugeluting and radioactive stents may also have a future role in the management of esophageal malignancy; these have been tested with success in animal models [12,13] . In cases where the distal margin of the stent crosses the gastro-esophageal (GE) junction there are now SEMS available with an anti-reflux mechanism. Survival has been shown to be reduced in patients in whom the stent crossed the GE junction [14] . A study which compared an open stent with the Z-stent with Dua antireflux valve found that 96% of patients with the open stent had reflux symptoms, compared with 12% with the antireflux mechanism [15] . Several other SEMS with antireflux mechanisms have been manufactured. Further work will be required to determine the overall efficacy and complic...

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Colonic stenting as bridge to surgery versus emergency surgery for management of acute left-sided malignant colonic obstruction: a multicenter randomized trial (Stent-in 2 study)

Cited by 42 publications

References 22 publications

Self-expanding metallic stent as a bridge to surgery versus emergency surgery for obstructive colorectal cancer: a meta-analysis

Self-expanding metallic stent as a bridge to surgery versus emergency surgery for obstructive colorectal cancer: a meta-analysis

Treatment of left-sided colonic emergencies: a comparison of US, UK and Australian surgeons

Endoscopic stenting-Where are we now and where can we go?

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