Endoscopic stenting is not as effective for palliation of colorectal obstruction in patients with advanced gastric cancer as emergency surgery

Colorectal Stents: Current Status

“…A technically successful SEMS insertion was achieved in 67% to 96%, while clinical success was attained in 20% to 96% in this clinical scenario. 20 , 21 , 22 Although these outcomes may be slightly worse than those of SEMS insertion for primary CRC obstruction, palliative SEMS can still be indicated in patients with colonic obstruction from extracolonic malignancy, especially in those with a relatively short expected survival time and those who are poor surgical candidates. 22 …”

Clinical Impact of Sarcopenia on Gastric Cancer

“…These figures are higher than those of other reports. Because invasive or metastatic gastric cancer frequently causes stenosis of the digestive tract, which leads to emaciation(44,45), sarcopenia might thus have been confounded with advanced gastric cancer.Tamandl et al have analyzed patients with esophageal or esophagogastric junctional cancer, and they have demonstrated that sarcopenia could be a prognostic factor of overall survival along with the T factor and a positive surgical margin(26). Huang et al have investigated prognostic factors related to the 1-year survival rate in gastric cancer patients(30), and they have also reported that sarcopenia is an independent prognostic factor, in patients aged over 75 years, with NRS 2002 score, degree of differentiation, surgical procedures (total gastrectomy or partial resection), and combined resection of other organs.…”

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

“…Although a recent study reported that endoscopic stenting is not as effective for palliation of colorectal obstruction in patients with advanced gastric cancer as emergency operation, the difference between extracolonic malignancy and colorectal cancer might be due to colonic immobilization or multiple stenosis due to carcinomatosis [9]. 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.…”

“…Therefore, when we carefully assess stenotic lesions and high-risk factors for complications in gastric cancer with carcinomatosis, SEMS is still the most preferred option to relieve the obstruction. It has been reported that the presence of fewer than two obstructive sites was a predictive factor for successful stenting [9]. On the other hand, in patients with multiple stenoses, colostomy, if possible, might be superior to treatment with SEMS placement because of the high probability of bowel occlusion at other locations.…”