New procedure for the treatment of colorectal neoplastic obstructions

Tejero, Eloy; Mainar, Ana M.; Fernández, L.; Tobio, R.; Gregorio, Miguel Ángel De

doi:10.1007/bf02049822

Cited by 242 publications

(123 citation statements)

References 3 publications

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“…It is estimated, that in the case of a colorectal cancer, obstruction occurs in 10% to 28% of cases, and during the treatment of an ovarian carcinoma, it occurs in 20% to 50% of patients [1][2][3]. In patients with advanced ovarian carcinoma, enteral obstruction is an insidious process developing over weeks and yielding to a spontaneous remission under therapy between successive obstructive interludes.…”

Section: Discussionmentioning

confidence: 99%

“…He used a metallic endoprosthesis to restore intestinal patency in a patient with an inoperable rectal carcinoma. Tejero et al described the use of an enteral stent in a patient with an operable recital carcinoma, although with concomitant obstruction [3]. It was the first application of an enteral stent to decompress the intestine and to prepare the patient for surgical resection.…”

Section: Introductionmentioning

confidence: 99%

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Using our own developed stent in the palliative treatment of obstruction in the left half of the colon due to ovarian cancer

et al. 2017

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Objectives: An assessment of implantation efficacy and safety of self-developed self-expanding stent in patients with an ovarian cancer induced by intestinal obstruction. Material and methods:The study of the stenting efficacy and safety was realized prospectively. The group consisted of 13 patients with left half colon obstruction due to an inoperable metastatic ovarian carcinoma. All the patients had a histopathologically diagnosed ovarian carcinoma and were treated in the past both surgically and systemically. Stenting was preceded by a Computed Tomography (CT) scan confirming and locating the obstruction. Patients with a multilevel intestinal obstruction were disqualified.Results: Nine stents were implanted in the rectosigmoid; 4 stents were implanted in an externally compressed rectum. One migration of implanted stent was observed. In one case 2 stents were implanted due to an insufficient coverage of the stricture. The decompression of the obstruction of the gastrointestinal tract was achieved in 11 patients (85%). Conclusions:1) The implantation of our own developed, self-expanding stent is effective and safe.2) The implantation of the stent in patients with an inoperable ovarian cancer causing an obstruction of the gastrointestinal tract is an effective procedure limiting postoperative complications and improving life comfort by avoiding stoma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using our own developed stent in the palliative treatment of obstruction in the left half of the colon due to ovarian cancer

et al. 2017

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“…Colorectal stents are being used for palliation and as a "bridge to surgery" in obstructing colorectal carcinoma. Tejero et al 23 described new procedure for the treatment of colorectal neoplastic occlusion which involves the following three phases: first, placing a metallic stent at the point of the stenosis of the colon, which enables the acute obstruction phase to be solved; second, recovering the general state of the patient, make an definite treatment plan, and mechanically preparing the colon; third, performing regulated and final surgery. Choo et al 24 …”

Section: Nitinol Colorectal Stentmentioning

confidence: 99%

Gastrointestinal Stent Update

Kang

2010

Gut Liver

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The use of self-expanding metallic stents in the upper gastrointestinal tract, placed under radiologic imaging or endoscopic guidance, is the current treatment of choice for the palliation of malignant gastrointestinal outlet obstructions. Advances in metallic stent design and delivery systems have progressed to the stage where this treatment is now considered a minimally invasive therapy. Metallic stent placement will broaden further into the field of nonsurgical therapy for the gastrointestinal tract. To date, metallic stents placed in the esophagus, gastric outlet, colorectum, and bile ducts are not intended to be curative, but rather to provide a palliative treatment for obstructions. The evolution of metallic stent technology will render such procedures not only palliative but also therapeutic, by enabling local drug delivery, and the use of biodegradable materials will reduce procedure-related complications. (Gut Liver 2010;4(Suppl. 1):S19-24)

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“…In the early 1990s, SEMS were first used for palliation of advanced malignancy (6), being later used to relieve acute obstruction, as a "bridge" to elective surgery (7). Although effectiveness of the use of colonic SEMS in a palliative or bridge-to-surgery indication is broadly recognized, some have questioned the safety of colonic stenting, particularly as it pertains to colonic perforation (8,9).…”

Section: Introductionmentioning

confidence: 99%

Outcome of endoscopic self-expandable metal stents in acute malignant colorectal obstruction at a tertiary center

Rodrigues‐Pinto¹,

Pereira²,

Lopes³

et al. 2015

Rev Esp Enferm Dig

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Background: Malignant colorectal obstruction (MCRO) by advanced colonic cancer occurs in 8-13% of colonic cancer patients. Emergent surgery carries a high mortality and morbidity risk. Endoscopic self-expanding metal stents (SEMS) may be used in acute MCRO.Aim: Evaluate clinical outcome of SEMS in acute MCRO and efficacy of SEMS placement considering fluoroscopy guidance.Methods: Retrospective study of patients with acute MCRO that placed SEMS in a 3 years period.Results: SEMS were placed in 47 patients, followed-up for a median time of 150 days. The intent of stenting was bridge to definitive surgery in 40% of the patients (n = 19) and palliation in the remaining 60% (n = 28). The location of the tumor did not influence the presence of lymph node involvement (p = 0.764) nor metastasis (p = 0.885). Mortality rate at year 1 was 61%. Survival was significantly higher in patients submitted later to combination therapy compared to chemotherapy, surgery or symptomatic treatment (p < 0.001). Fluoroscopy was used in 57% of the procedures. Clinical success was 79%. A second SEMS was needed during the procedure in 6% of the patients. Rate of early and late complications was 11% and 5%, respectively. Fluoroscopy guidance did not influence the occurrence of immediate (p = 0.385), early (p = 0.950) or late complications (p = 0.057). Thirty-three percent of patients underwent surgery at a later stage, with neo-adjuvant therapy in 18%.Conclusions: SEMS provide a relative safe and successful treatment in a palliative or bridge-to-surgery indication. No significant differences were found in SEMS placement success, early complications or late complications considering fluoroscopy guidance.

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New procedure for the treatment of colorectal neoplastic obstructions

Abstract: This procedure is both safe and effective and could become the method of choice for the treatment of colorectal neoplastic obstructions.

Cited by 242 publications

References 3 publications

Using our own developed stent in the palliative treatment of obstruction in the left half of the colon due to ovarian cancer

Using our own developed stent in the palliative treatment of obstruction in the left half of the colon due to ovarian cancer

Gastrointestinal Stent Update

Outcome of endoscopic self-expandable metal stents in acute malignant colorectal obstruction at a tertiary center

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