Role of self expandable stents in management of colorectal cancers

Abstract

Acute malignant colorectal obstruction is a complication of colorectal cancer that can occur in 7%-29% of patients. Self-expanding metallic stent placement for malignant colorectal obstruction has gained popularity as a safe and effective procedure for relieving obstruction. This technique can be used in the palliation of malignant colorectal obstruction, as a bridge to elective surgery for resectable colorectal cancers, palliation of extracolonic malignant obstruction, and for nonmalignant etiologies such as anastomotic strictures, Crohn's disease, radiation therapy, and diverticular diseases. Self-expanding metallic stent has its own advantages and disadvantages over the surgery in these indications. During the insertion of the self-expanding metallic stent, and in the follow-up, short term and long term morbidities should be kept in mind. The most important complications of the stents are perforation, stent obstruction, stent migration, and bleeding. Additionally, given the high risk of perforation, if a patient is treated or being considered fortreatmentwith antiangiogenic agents such as bevacizumab, it is not recommended to use self-expanding metallic stent as a palliative treatment for obstruction. Therefore, there is a need for careful clinical evaluation for each patient who is a candidate for this procedure. The purpose of this review was to evaluate self-expanding metallic stent in the management of the obstruction of the colon due to the colorectal and extracolonic obstruction.

Mechanisms, Management, and Treatment of Fibrosis in Patients With Inflammatory Bowel Diseases

“…Endoscopic metallic stents have been successfully used for strictures of some other conditions, such as esophageal or colonic malignancies 131, 132 . Observational data are available for CD-associated strictures.…”

Efficacy of uncovered self-expandable metallic stent for colorectal obstruction by extracolonic malignancy

“…Colorectal obstruction is a common complication of colorectal cancer, and usually requires rapid intervention due to bacterial translocation, dehydration, electrolyte imbalance, and increased risk of colonic perforation[ 1 , 2 ]. Since its development by Dohmoto in 1991, endoscopic self-expandable metallic stent (SEMS) insertion has become the main therapeutic option as a bridge to surgery and palliation of colorectal obstruction caused by inoperable colorectal cancer (CRC)[ 3 - 7 ]. Besides CRC, less than 20% of colorectal obstructions are caused by extracolonic malignancy (ECM) through peritoneal metastasis, colonic direct invasion, or extraluminal compression[ 8 ].…”

In�vivo and in�vitro induction of the apoptotic effects of oxysophoridine on colorectal cancer cells via the Bcl‑2/Bax/caspase-3 signaling pathway

“…Colorectal cancer (CRC) is one of the most common gastrointestinal malignancies worldwide ( 1 , 2 ). In previous years, with the improvement of living conditions, increases in lifespan and alterations to environmental pollution factors, the morbidity and mortality of colorectal cancer has increased significantly, alongside a decrease in the age of disease onset ( 3 – 5 ). The pathogenesis of colorectal cancer is complex, and therefore diagnosis is often difficult in the earlier stages of disease ( 6 ).…”