Treatment of a radiation-induced sigmoid stricture with an expandable metal stent

Expandable metal stent placement for benign colorectal obstruction: outcomes for 23 cases

“…Paul et al [11] speculated that risk is greater when metallic stents are placed in acutely inflamed colonic segments. Radiation-induced strictures are especially friable and may be associated with a higher complication rate [11,29]. Both perforations in our series occurred in the setting of diverticulitis.…”

Colorectal Stenting for Malignant and Benign Disease: Outcomes in Colorectal Stenting

“…To our knowledge, after performing a detailed literature search, only 20 patients from different case series or individual case reports have been reported to have undergone stent insertion for benign obstruction. [10][11][12][13][14][15][16][17][18][19][20][21][22] The indications and outcomes are shown in Table 2. Some of these patients had repeated sessions of balloon dilation before stent insertion but failed to maintain luminal patency.…”

“…Four of these patients had elective surgery early after stent insertion without the need for a temporary stoma. Of nine patients who had long-term follow-up (mean follow-up, 19 months), prolonged luminal patency was 11 Crohn's disease Not reported 5 months >4.5 years 12 11 Crohn's disease Covered Z-stent 10 months >3 years 13 17 Crohn's disease Wallstent (Operation 3 weeks after procedure) 14 10 Diverticular disease Wallstent 22 mm No migration (operation 6 days after procedure) 15 18 Diverticular disease Wallstent 20 mm Migration Not available 16 18 Diverticular disease Wallstent 18 mm Migration Not available 17 19 Radiation colitis Wallstent 16 mm 3 weeks >11 months 18 20 Radiation colitis Wallstent 20 mm No migration >4 months 19 21 Granulation Wallstent 22 mm No migration >1 year 20 22 Not available Choo stent Within 3 weeks Not available obtained despite frequent stent migration. Although Odurny 16 questioned the long-term efficacy of stenting in benign strictures, this intervention seemed to provide longer relief of symptoms than balloon dilation and prevented the need for invasive surgery.…”

Systematic review for non-surgical interventions for the management of late radiation proctitis

“…Non-surgical dilatation has been attempted. Three relevant studies were identified and included two case reports of the use of a dilator (Triadafilopoulos and Sarkisian, 1990) or stent (Yates and Baron, 1999) and one series of four cases which were endoscopically dilated (Johansson, 1996). Although the strictures are described they are not scored and the absence of a formal baseline assessment and objective response means that the effect which appears to be beneficial in each report cannot be quantified, nor can the duration of response be determined from the data available.…”

“…Side effects include one case of brief post dilatation bowel pain and another case of perforation. Quality of life issues are referred to in one report where the patients' general health was felt to improve as a result of the treatment (Yates and Baron, 1999). The reports describe slightly different interventions and outcome parameters so that they cannot be compared and a summary statistic cannot be derived.…”