Endoscopic stent placement in the management of malignant colonic obstruction: Experiences from two centers

Gürbulak, Bünyamin; Gürbulak, Esin Kabul; Akgün, İsmail; Buyukasik, Kenan; Bektaş, Hasan

doi:10.5152/ucd.2015.2828

Cited by 4 publications

(5 citation statements)

References 14 publications

(13 reference statements)

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“…The 33.3% of the patients were stented for palliation. The mean follow-up period of these cases was 8 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) months, and the patients were lost because of their preexisting diseases. Any complication did not develop during stent placement for bridging to surgery, and any case of mortality was not observed due to stent application.…”

Section: Resultsmentioning

confidence: 99%

“…[9,10] In patients with poor general condition or in the presence of widespread disease, such as peritoneal carcinomatosis, irresectable metastasis, and irresectable T4 tumors, SEMS has been widely accepted as an alternative method to emergency surgery to convert emergency state to elective state in cases of resectable tumors so as to eliminate the disadvantages that may be caused by emergency operation or with the purpose of palliation. [11,12] In SEMS application, owing to technical reasons, such as bowel contamination, non-visualization of the tumor, and failure to negotiate the guidewire or stent, success may not be achieved. In a study with a median follow-up period of 106 (68-288) days, technical and clinical success rates of SEMS were reported to be 96.2% and 92%, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative Endoskopic Stent Application for Bridging or Paliative Purposes in Obstructive Left Colon and Rectal Tumors

Kaya¹

2019

South Clin Ist Euras

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The outcomes of endoscopic enteral stent applications in left colon or rectal cancers were evaluated. Methods: All patients who received stent application between January 2016 and December 2017 for obstructive left colon and rectal cancers were retrospectively evaluated. Demographic data, obstructed side, indications, technical and clinical success of the procedure, and also mortality and morbidity rates were recorded. Results: Stents were successfully placed in 12 (85.7%) out of 14 cases. Eight cases received stents for bridge to elective surgery, whereas four had stents for palliative purposes. In one of the palliative cases, Hartman procedure was applied due to perforation at the proximal side of the stent after 3 months. The technical and clinical success rates were 85.7% and 91.7%, respectively. There was no mortality. Conclusion: Application of self-expanding metallic stent in patients with advanced stage obstructive colorectal cancer may be an alternative method compared with emergency surgeries. It can be safely and effectively performed and offers opportunities for palliative treatments and elective surgeries.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preoperative Endoskopic Stent Application for Bridging or Paliative Purposes in Obstructive Left Colon and Rectal Tumors

Kaya¹

2019

South Clin Ist Euras

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“…Although the literature indicates that it is safe, certain conditions must be met for stent placement in colonoscopic perforations. Generally, these conditions are related to the hospital facilities, including the availability of an experienced endoscopist and associated assistant team and the availability of the proper stent and equipment when required (40).…”

Section: Discussionmentioning

confidence: 99%

Colonoscopic perforations: Single center experience and review of the literature

Çolak¹,

Gürbulak²,

Bektaş³

et al. 2017

Turk J Surg

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Colonoscopic perforations: Single center experience and review of the literature INTRODUCTION Colonoscopy is accepted as the gold standard imaging modality for the diagnosis of colon and distal ileum diseases. It aids the detection of smaller lesions and tissue sampling and also functions as a therapeutic procedure for intestinal diseases. Similar to other invasive procedures, colonoscopy has been associated with various complications; among these, perforation is the most important. Iatrogenic colonic perforation has high rates of mortality and morbidity. It is mainly divided into two categories: diagnostic and therapeutic (1, 2). Management includes both medical and surgical approaches. However, the best approach for treatment depends on various factors, such as the patient's general condition, age, comorbidities, and, most importantly, the time between the onset and diagnosis of perforation. In this study, we aimed to evaluate the incidence of perforation in a large colonoscopy series, discuss patient management strategies, and analyze the clinical consequences of iatrogenic colonic perforation. MATERIAL AND METHODSBetween January 2005 and May 2015, a total of 31,655 lower GIS endoscopies were performed at our center. Patients with iatrogenic colonic perforations were investigated retrospectively. All procedures were conducted under sedoanalgesia. The procedures were performed by 27 endoscopists, including 24 general surgeons and 3 gastroenterology specialists. The experience of the endoscopists varied between 2 and 15 years.We analyzed the demographic characteristics of the patients, the type of procedure (therapeutic or diagnostic), indications for colonoscopy and associated colonic disease, location and detection time of perforation, management strategy (operative or nonoperative), and complications.The perforations were detected either during colonoscopy by observing a visible defect in the colonic wall (mesenteric or antimesenteric side) or after the procedure by detecting free intra-abdominal air upon radiological examination. Patients who complained of abdominal pain or distention following 195Objective: Iatrogenic colonic perforation is a well-known complication that can increase mortality and morbidity in patients undergoing colonoscopy. Closer follow-up and a well-planned treatment strategy are required when perforation arises as a complication. The aims of this study are to (1) report our experience with a large colonoscopy series; (2) evaluate the underlying mechanisms of iatrogenic colonic perforation; (3) discuss the ideal period between onset and treatment; and (4) review the current literature regarding the management of iatrogenic colonic perforations. Material and Methods:Patients who underwent colonoscopy between January 2005 and May 2015 at a single center were reviewed retrospectively. Procedures during which colonic perforations occurred were documented and analyzed.Results: Between January 2005 and May 2015, 31,655 patients underwent colonoscopy and 5,214 patients underwent recto-sigmoi...

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“…164 With respect to colonic SEMS, a large prospective series of 513 patients and 6 retrospective studies found the risk of clinically relevant haemorrhage within 7 days to be 0%. [165][166][167][168][169][170][171][172][173][174] A systematic review identifying 40 studies on SEMS for the management of emergency malignant large bowel obstruction identified 9 studies reporting on clinical relevant bleeding which occurred in 0.5% (8 out of 1474 patients). 175 We have considered endoscopic stenting at all sites in the GI tract to be low risk for haemorrhage within 7 days.…”

Section: Endoscopic Stentingmentioning

confidence: 99%

Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update

Veitch

Radaelli

Alikhan

et al. 2021

Gut

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This is a collaboration between the British Society of Gastroenterology (BSG) and the European Society of Gastrointestinal Endoscopy (ESGE), and is a scheduled update of their 2016 guideline on endoscopy in patients on antiplatelet or anticoagulant therapy. The guideline development committee included representatives from the British Society of Haematology, the British Cardiovascular Intervention Society, and two patient representatives from the charities Anticoagulation UK and Thrombosis UK, as well as gastroenterologists. The process conformed to AGREE II principles and the quality of evidence and strength of recommendations were derived using GRADE methodology. Prior to submission for publication, consultation was made with all member societies of ESGE, including BSG. Evidence-based revisions have been made to the risk categories for endoscopic procedures, and to the categories for risks of thrombosis. In particular a more detailed risk analysis for atrial fibrillation has been employed, and the recommendations for direct oral anticoagulants have been strengthened in light of trial data published since the previous version. A section has been added on the management of patients presenting with acute GI haemorrhage. Important patient considerations are highlighted. Recommendations are based on the risk balance between thrombosis and haemorrhage in given situations.

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Endoscopic stent placement in the management of malignant colonic obstruction: Experiences from two centers

Cited by 4 publications

References 14 publications

Preoperative Endoskopic Stent Application for Bridging or Paliative Purposes in Obstructive Left Colon and Rectal Tumors

Preoperative Endoskopic Stent Application for Bridging or Paliative Purposes in Obstructive Left Colon and Rectal Tumors

Colonoscopic perforations: Single center experience and review of the literature

Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update

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