Stenting for colorectal cancer obstruction compared to surgery—a study of consecutive patients in a single institution

Haglind, Eva; Asplund, Dan; Bergström, Maria; Park, Per-Ola

doi:10.1007/s00384-011-1374-6

Cited by 30 publications

(23 citation statements)

References 39 publications

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“…When combined with bevacizumab, the risk of perforation increases [85]. Two recent studies found a similar complication rate in patients treated surgically and in those with stents [93,94]. Complications of SEMS use has been reported in patients with low volumes of hepatic replacement by metastases, as these patients risk outliving the stent's viability [87].…”

Section: Non-surgical Management Of Malignant Obstructionmentioning

confidence: 74%

“…Any treatment of colonic obstruction requires decompression to prevent colonic necrosis and perforation [85]. Stents can reach this endpoint without the risks associated with surgical trauma in high-risk patients [93]. Multiple studies have confirmed an improved outcome in patients treated with SEMSs as an elective rather than an emergency procedure.…”

Section: Non-surgical Management Of Malignant Obstructionmentioning

confidence: 99%

“…Overall, the stent-related death rate remains less than 0.6% with a median survival of 5 months [11]. In light of these complications, it is recommended that patients should be carefully observed, with generous laxative use, and those who cannot be closely monitored should be treated by diverting colostomy [92,93].…”

Section: Non-surgical Management Of Malignant Obstructionmentioning

confidence: 99%

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Recent Advances in the Management of Stage IV Colon Cancer

Kanthan¹,

Senger²,

Ahmed³

et al. 2012

JCT

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Colon cancer is the second commonest cause of cancer-related death in Canadian men and women, with approximately one-third of patients dying from this disease. One quarter of patients present with metastases initially, and up to half of all colon cancer patients will develop stage IV disease over the course of their life. Despite ongoing advances in the evolution of newer cytotoxic drugs, targeted biological agents and improved metastasectomy techniques, the gain in overall survival in these patients is of low magnitude. This manuscript is a targeted review of the recent advances over the last decade in the management of advanced stage IV colon cancer as available in the published English literature. The two major arms of metastatic colon cancer management that include surgery and systemic chemotherapy and palliative measures as available are discussed. A multi-modality team-based approach involving medical oncologists, surgical oncologists, radiologists, and other health-care providers continues to be critical for ongoing success in the therapeutic management of these patients. Future studies of well-designed prospective, randomized-controlled clinical trials to develop and evaluate newer therapeutic strategies are recommended for continued and improved understanding for optimization of clinical management in advanced colon cancer.

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Section: Non-surgical Management Of Malignant Obstructionmentioning

confidence: 74%

Section: Non-surgical Management Of Malignant Obstructionmentioning

confidence: 99%

Section: Non-surgical Management Of Malignant Obstructionmentioning

confidence: 99%

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Recent Advances in the Management of Stage IV Colon Cancer

Kanthan¹,

Senger²,

Ahmed³

et al. 2012

JCT

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“…Inzwischen zeigen mehrere direkte Vergleichsstudien zwischen Stentimplantation als «bridge to surgery» und Notfalloperation einerseits eindeutige Vorteile für die Stentgruppe [17,18], andererseits keine Vorteile für die Stentimplantation [19] bzw. in wenigen Serien eine Überlegenheit der operativen Therapie auch in der Notfallsituation [20,21].…”

Section: Literaturanalyse 1990–2012 Mit Schwerpunkt 2011/2012unclassified

Kolonstents als «Bridge to Surgery»

Grund¹,

Zipfel²

2012

Visc Med

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Hintergrund: Die Implantation von selbstexpandierenden Metallstents (SEMS) in das Kolorektum – insbesondere als «bridge to surgery» – hat sich zunehmend etabliert, obwohl die Charakteristika des Kolons eine Prothesenimplantation erschweren und bisher noch keine optimalen Stents für diese Lokalisation verfügbar sind. Mit einem Stent lässt sich beim Kolonileus sehr patientenschonend eine sofortige Dekompression des Darms herbeiführen und die sonst notwendige Notfalloperation mit hoher Letalität und Komplikationsrate vermeiden. Methode: Literaturübersicht. Ergebnisse: Trotz zahlreicher positiver Studienergebnisse («... Stenting ist sehr effektiv, sicher und komplikationsarm im Vergleich zur Operation ...») ergibt eine kritische Analyse der Publikationen aufgrund vieler Faktoren (Patientenselektion, Stenttyp, Implantationsmethode usw.) jedoch eine hohe Heterogenität. Schlussfolgerungen: Um gute Resultate zu erzielen, sollte eine Stentimplantation ins Kolon nur nach strenger Indikationsstellung von einem erfahrenen Endoskopiker durchgeführt werden. Dabei ist auch die mögliche Alternative einer endoskopisch eingelegten Dekompressionssonde zu prüfen; ebenso sind onkologische Gesichtspunkte (chirurgische Resektion als einziger kurativer Ansatz) zu beachten.

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“…Twenty-two patients (26.8%) had a complication of which 16 (19.5%) underwent urgent surgery for insufficient functioning of the stent; there were Significant complications of stent placement include perforation and bleeding and overall complication rates have been reported in approximately 4-40% of cases [6][7][8][9][10][11][12][13][14] . Of particular concern is perforation of the tumor, since it could lead to peritoneal tumor spill and dissemination of tumor cells [6,10,13,[15][16][17] .…”

Section: Introductionmentioning

confidence: 99%

Radiological Position and Clinical Outcome of Preoperative Self-Expanding Metal Stents for Obstructing Colonic Cancer: A Single-Centre Cohort Study

Berg

Bergmann²,

Ledeboer³

et al. 2015

Dig Surg

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Background: Preoperative placement of self-expanding metal stents is used in patients with obstructing colon carcinoma to prevent an emergency operation. The perceived benefits remain the subject of discussion. The data-evaluating function and complications of stents in relation to radiological position are limited. Methods: Patients receiving a preoperative stent between 2003 and 2013 were retrospectively analysed in this single-centre study. We analysed radiological deployment, eccentricity and angulation of the stent directly after placement. Endpoints were clinical success (resolution of ileus), complications needing non-elective surgery (blow-out, perforation, persistent ileus, dislocation) and other complications (bleeding, infiltrate). Associations were corrected for other potential influences. Results: Eighty-two patients were included. In 22 patients (26.8%), the stent was placed proximal to the splenic flexure. Clinical success was present in 85.4%. Twenty-two patients (26.8%) had a complication of which 16 (19.5%) underwent urgent surgery for insufficient functioning of the stent; there were two blow-outs (2.4%). A more symmetrically placed stent was associated with clinical success (p = 0.042), with large overlap between groups. However, no association was found with non-elective surgery or complications. Also, angulation and deployment were unassociated with these outcomes. Conclusions: We could not establish an association between symmetry, angulation or deployment of self-expandable colonic stents with clinical success and complications.

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Stenting for colorectal cancer obstruction compared to surgery—a study of consecutive patients in a single institution

Cited by 30 publications

References 39 publications

Recent Advances in the Management of Stage IV Colon Cancer

Recent Advances in the Management of Stage IV Colon Cancer

Kolonstents als «Bridge to Surgery»

Radiological Position and Clinical Outcome of Preoperative Self-Expanding Metal Stents for Obstructing Colonic Cancer: A Single-Centre Cohort Study

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