Outcome of patients after endoluminal stent placement for benign colorectal obstruction

Abstract

SEMS is a good treatment option for patients with anastomotic stricture of the colon and for patients with benign colonic stricture who are unfit for surgery. SEMS can be used as a bridge to surgery in diverticular obstruction but there seems to be a considerable risk of complications. If a SEMS is placed into a diverticular stricture, the planned bowel resection should be performed within a month.

Endoprosthetic management of refractory ileocolonic anastomotic strictures after resection for Crohnʼs disease: Report of nine-year follow-up and review of the literature

“…2,6,7,9,12 Benign obstruction represents a different challenge, however, and there is no consensus in the scant literature as to whether the same efficacy and safety profiles will hold true. While some studies report failure rates over 60% and a high frequency of complications, particularly in the setting of diverticular disease, 3,9,15,[18][19][20] many authors conclude that for selected patients, endoluminal stenting can be an important treatment option. 9,15,19,20 CD is a common cause of benign obstruction that is frequently refractory to medical management and a source of tremendous disability.…”

“…While some studies report failure rates over 60% and a high frequency of complications, particularly in the setting of diverticular disease, 3,9,15,[18][19][20] many authors conclude that for selected patients, endoluminal stenting can be an important treatment option. 9,15,19,20 CD is a common cause of benign obstruction that is frequently refractory to medical management and a source of tremendous disability. 1,21 While surgery remains the standard of care, it is not curative and can even exacerbate disease-related morbidity in the long run by necessitating further interventions for adhesions and recurrence.…”

“…6,8,[18][19][20] From our review of the literature, we identified only nine studies that report on SEMS in CD, in a total of 12 patients and 15 procedures. 2,3,[9][10][11][12][13][14][15] Outcome data are summarized in Table 2. In five patients (45%) the indication for stent placement was anastomotic stricture.…”

“…While initial success rates are high, migration seems to occur more frequently in benign disease 8 and planned surgical removal generally curtails any extended outcome data. 3,9 The literature is particularly scarce regarding inflammatory bowel disease, with only a handful of studies reporting on no more than one to two CD patients each, 2,3,[9][10][11][12][13][14][15] and only three cases with stent durations greater than 1 year. 12,13,15 There is concern that prolonged stenting in CD may lead to more complications such as recurrent inflammation, fistula formation, and perforation.…”

Endoscopic fixation of the rectum for rectal prolapse: a feasibility and survival experimental study

“…With the safety, feasibility, and at least equal long-term results compared to open surgery, the application of laparoscopic surgery for certain diseases like colorectal cancer has been well accepted [1][2][3][4][5]. Surgical innovation has not stopped at this frontier and has proceeded further along the more minimal access routes like single-port surgery, natural orifice transluminal endoscopic surgery (NOTES), and endoluminal surgery [6,7].A common application of endoluminal intervention (beyond mucosal polyp excision) has been to tackle bowel obstruction, either as a bridge to surgery or as a solution in a more advanced disease status [8][9][10][11]. The endoluminal surgical approach to disease therapies offers a less invasive method compared to currently available surgical…”