Combination endo‐radiological colorectal stenting: a prospective 5‐year clinical evaluation

Baraza, Wal; Lee, F.; Brown, Steven R.; Hurlstone, David P.

doi:10.1111/j.1463-1318.2008.01512.x

Cited by 21 publications

(11 citation statements)

References 16 publications

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“…Although migration of an uncovered stent (as was used in the dog of the present report) is less likely than with a covered stent, tumor ingrowth through uncovered stent gaps can result in reobstruction and a necessity for restenting. 10,18,23 Lastly, marked improvement in clinical signs was not noted until 7 weeks after stent placement in the dog of the present report. Owners should be prepared for the possibility that dogs with placement of a colorectal stent for palliation may need to continue oral administration of medications indefinitely, and clinical signs may show slow improvement until the proper combination of medications and colorectal patency is achieved.…”

Section: Discussioncontrasting

confidence: 48%

“…Potential long-term complications related to the stent may have included tumor ingrowth through stent gaps resulting in obstruction, migration, and stent fracture. 10,23 Second, as malignant transformation can occur with colorectal neoplasia, it is recommended that dogs with benign masses (such as was originally found in the dog of the present report) be evaluated periodically after stent placement with thoracic radiography, abdominal ultrasonography, and colonoscopy (including biopsy) to assess progression. 4,7,22 Colonoscopy is also useful in the assessment of tumor ingrowth.…”

Section: Discussionmentioning

confidence: 97%

“…9,10,17,20 The episode of constipation that occurred approximately 3 months after stent placement may be attributable to the elimination of lactulose from the dog’s treatment regimen in an effort to control the diarrhea. In a clinical report 1 of colonic stenting in 2 cats that survived nearly 7 months after stent placement, the cats continued to receive oral administration of lactulose and a low-residue diet g to maintain soft feces.…”

Section: Discussionmentioning

confidence: 99%

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Use of a nitinol stent to palliate a colorectal neoplastic obstruction in a dog

Culp

MacPhail

Perry

et al. 2011

javma

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Case Description A 12-year-old castrated male Labrador Retriever was evaluated for clinical signs associated with colorectal obstruction. Clinical Findings The dog had a 2-week history of tenesmus and hematochezia. On rectal examination, an annular colorectal mass was palpable extending orad into the pelvic canal. The original diagnosis of the colorectal mass was a mucosal adenoma. The dog was maintained on a low-residue diet and fecal softeners for a period of 13 months after initial diagnosis. At that time, medical management was no longer effective. Treatment and Outcome Placement of a colonic stent was chosen to palliate the clinical signs associated with colorectal obstruction. By use of fluoroscopic and colonoscopic guidance, a nitinol stent was placed intraluminally to open the obstructed region. Placement of the stent resulted in improvement of clinical signs, although tenesmus and obstipation occurred periodically after stent placement. At 212 days after stent placement, the patient had extensive improvement in clinical signs with minimal complications; however, clinical signs became severe at 238 days after stent placement, and the dog was euthanized. Histologic evaluation of the rectal tumor from samples obtained during necropsy revealed that the tumor had undergone malignant transformation to a carcinoma in situ. Clinical Relevance A stent was successfully placed in the colon and rectum to relieve obstruction associated with a tumor originally diagnosed as a benign neoplasm. Placement of colorectal stents may be an option for the palliation of colorectal obstruction secondary to neoplastic disease; however, clinical signs may persist, and continuation of medical management may be necessary.

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Use of a nitinol stent to palliate a colorectal neoplastic obstruction in a dog

Culp

MacPhail

Perry

et al. 2011

javma

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“…There have even been some reports suggesting that stent placement is more difficult to perform in the descending colon or splenic flexure than in the rectum or sigmoid colon. 4,11,21 In our study, similar difficulties were observed in cases of the stent placement using radiologic method alone: inability to pass the guidewire through the obstructive lesion due to tortuous, curved angulation of the sigmoid colon (n=2), and the difficult approach of the angiographic catheter into a lesion located in the transverse colon (n=1).…”

Section: Discussionsupporting

confidence: 70%

Comparison of Clinical Outcomes between Endoscopic and Radiologic Placement of Self-expandable Metal Stent in Patients with Malignant Colorectal Obstruction

Kim

Jeong

Lee

et al. 2013

Korean J Gastroenterol

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Background/Aims: This study compared the clinical outcomes between endoscopic and radiologic placement of self-expandable metal stent (SEMS) in patients with malignant colorectal obstruction. Methods: In total, 111 patients were retrospectively enrolled in this study between January 2003 and June 2011 at Seoul National University Boramae Hospital. Technical and clinical success rates, complication rates, and stent patency were compared between using an endoscopic (n=73) or radiologic (n=38) method during the SEMS placement procedure. Results: The technical success rate was higher in the endoscopic method than in the radiologic method (100% [73/73] vs. 92.1% [35/38], respectively; p=0.038). In addition, in 3 of the remaining 35 patients in the radiologic-method group, adjuvant endoscopic assistance was required. In the six patients (including the three aforementioned patients), the causes of technical failure were the inability to pass the guidewire into an obstructive lesion due to a tortuous, curved angulation of the sigmoid or descending colon (n=4), and a difficult approach to a lesion located at the descending or transverse colon (n=2). The clinical success rate, complication rate, and stent patency did not differ significantly between the two methods (p=0.424, 0.303, and 0.423, respectively). Conclusions: When the colorectal obstruction had a tortuous, curved angulation of the colon or was located at or proximal to the descending colon, the endoscopic method of SEMS placement appears to be more useful than the radiologic method. However, once SEMS placement was technically successful, the clinical success rate, complication rate, and stent patency did not differ with the method of insertion. (Korean J Gastroenterol 2013;61:22-29)

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“…Vários estudos demonstram maior mortalidade pós-operatória em pacientes operados na urgência 10,26,27 . No presente estudo, não foi possível avaliar e comparar a mortalidade tardia nos dois grupos, pois muitos pacientes foram encaminhados para terapia complementar em serviços de referência e perderam seguimento no HU-USP.…”

Section: Discussionunclassified

Ressecções eletiva e de urgência para tratamento de neoplasia maligna do cólon em hospital universitário: estudo de 66 casos

Borba

Brochado

Alcântara

et al. 2011

Rev bras. colo-proctol.

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120BORBA MR, BROCHADO MCRT, ALCÂNTARA PSM, LIMA TMA, ARANTES TS, OTOCH JP. Ressecções eletiva e de urgência para tratamento de neoplasia maligna do cólon em hospital universitário: estudo de 66 casos. Rev bras Coloproct, 2011;31(2): 120-125.Resumo: o câncer de cólon é uma doença de alta prevalência e mortalidade, cujo tratamento baseia-se na ressecção cirúrgica. A possibilidade de cura aumenta com o diagnóstico precoce, daí a importância dos programas de rastreamento populacional do câncer colorretal. o presente estudo analisou, retrospectivamente, 66 pacientes submetidos a ressecções do cólon por neoplasia em um perío-do de 58 meses no Hospital universitário da universidade de são Paulo. os pacientes foram divididos em dois grupos: grupo 1, submetidos a cirurgia eletiva (28 pacientes), e grupo 2, submetidos a cirurgia de urgência (38 pacientes). os grupos foram comparados com relação às variáveis sexo, idade, apresentação clínica, aspectos da técnica cirúrgica, sítio anatômico da lesão, estádio patológico, taxas de complicações, permanência hospitalar pós-operatória e óbitos na internação. Verificou-se no presente estudo que a idade entre os grupos foi semelhante. Houve uma predominância do sexo masculino entre os pacientes operados de urgência. No grupo de cirurgia eletiva, o principal sintoma foi a hematoquezia, enquanto os operados na urgência, tinham como principal queixa dor abdominal. A grande maioria dos pacientes, no momento da cirurgia, apresentava-se sintomática há meses. os pacientes operados na urgência apresentaram mais tumores pT4 e os operados eletivamente apresentaram mais neoplasias em estádio I. em ambos os grupos, o caráter oncológico dos procedimentos foi preservado, bem como foi alto o índice de anastomoses primárias (81,8%). As taxas de complicações pós-operatórias, o tempo de permanência hospitalar pós-operatório e a mortalidade foram semelhantes. Palavras-chave: câncer de cólon; urgência; complicações; cirurgia.Ressecções eletiva e de urgência para tratamento de neoplasia maligna do cólon em hospital universitário: estudo de 66 casos elective and urgency resections for the treatment of colon neoplasm in university Hospital: study of 66 cases

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Combination endo‐radiological colorectal stenting: a prospective 5‐year clinical evaluation

Abstract: Combination endoscopic/fluoroscopic colorectal stenting is effective and safe. It may be particularly useful in the stenting of more proximal colonic strictures.

Cited by 21 publications

References 16 publications

Use of a nitinol stent to palliate a colorectal neoplastic obstruction in a dog

Use of a nitinol stent to palliate a colorectal neoplastic obstruction in a dog

Comparison of Clinical Outcomes between Endoscopic and Radiologic Placement of Self-expandable Metal Stent in Patients with Malignant Colorectal Obstruction

Ressecções eletiva e de urgência para tratamento de neoplasia maligna do cólon em hospital universitário: estudo de 66 casos

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