Stent Performance in Obstructive Left Colon Cancer. Unicentric and Cross-sectional Study

Ríos, Sixto Javier Genzor; Trébol, María Teresa González-Nicolás; Prat, Naira Aguirre; Díaz, Miguel Cantalejo; Artigas, Juan Miguel Rodríguez; Peña, Joaquín Medrano; Guillén, R. Zaragozano; Bobadilla, José María Miguelena

doi:10.1016/j.cireng.2019.08.002

Cited by 2 publications

(2 citation statements)

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“…Covered and uncovered self‐expanding metal stents were used to occlude the enteric defect, with varying success. Stent migration, occlusion and erosion are concerns with this technique, informed mainly by the body of literature on the use of stents for malignant obstruction in which stent complications occur in up to one third of cases and can necessitate urgent surgery [14]. One additional modality, unrelated to endoscopy, is the placement of an occlusive plug within the fistula tract by an interventional radiologist [15].…”

Section: Discussionmentioning

confidence: 99%

“…Two (20%) patients had Class I obesity (BMI 30.0-34.9 kg/m 2 ) and three (30%) patients had Class II obesity (BMI 35.0-39.9 kg/m 2 ). Additional comorbidities included insulin-dependent diabetes mellitus in two stent complications occur in up to one third of cases and can necessitate urgent surgery [14]. One additional modality, unrelated to endoscopy, is the placement of an occlusive plug within the fistula tract by an interventional radiologist [15].…”

Section: Re Sultsmentioning

confidence: 99%

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Endoscopic management of colovesical and colovaginal fistulas with over‐the‐scope clips: A single‐institution case series

et al. 2021

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Aim: Conventional surgical management of colovesical and colovaginal fistulas can be morbid and is contraindicated in many patients. Our aim in this work is to evaluate our experience in the management of colovesical and colovaginal fistulas with endoscopic over-the-scope (OTS) clips. Method:A retrospective review of all patients who underwent attempted endoscopic OTS clip management of colovesical and colovaginal fistulas between 2013 and 2020 was performed. Preoperative risk factors, operative details and postoperative outcomes are reported.Results: Ten patients were identified. Fistula types were: colovesical (five), rectovesical (two), colovaginal (two) and rectovaginal (one). The aetiology of the fistula was diverticular disease in seven (70%) cases and surgical complication of pelvic surgery in three (30%).The mean defect age was 157 ± 98 days, the mean defect diameter was 4.5 mm (range 2-10 mm) and the mean fistula length was 15 mm (range 2-25 mm). In nine (90%) cases, fistula identification and cannulation were performed through the nonenteric lumen of the fistula. Initial management with an OTS clip was technically successful in eight (80%) patients. Of the eight patients who underwent OTS clip placement, long-term success (mean follow-up 218 days, range 25-673 days) was achieved after initial intervention in four (50%) patients. One patient underwent serial OTS clip procedures and achieved long-term success after four interventions; three patients have not undergone a repeat procedure after initial failure. Conclusion:Endoscopic management of colovesical and colovaginal fistulas with OTS clips offers a promising therapeutic option for patients with contraindications to conventional surgical management. Immediate technical success and long-term success rates are similar to other gastrointestinal tract applications of OTS clips.

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Section: Discussionmentioning

confidence: 99%

Section: Re Sultsmentioning

confidence: 99%