Treatment of colonic obstruction with expandable metal stents: radiologic features.

Canon, Cheri L.; Baron, Todd H.; Morgan, Desiree E.; Dean, Philip A. W.; Koehler, Robert E.

doi:10.2214/ajr.168.1.8976946

Cited by 97 publications

(76 citation statements)

References 16 publications

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“…Al though the presentsystemmakesit possibleto stent growths in the proximal colon, most pa tients who would benefit from stenting have distal colonic obstruction. In previous studies [5,7] of patients with resectablecancer, stent migration caused re current obstruction and incomplete bowel cleansing; however, in our study, the stent mi grated in only one patient, but obstruction did not recur in that patient. Our greater success could be due to the larger diameter of the en teral Wallstent (22 mm) compared with those designedfor esophagealuse (14â€"1 8 mm).…”

Section: Discussioncontrasting

confidence: 74%

“…In our study, one patient developed intestinal obstructionwhile awaiting electivesurgeryof a resectabletumor.The resultsofother studies [5,7] and our study suggest that elective colonic resectionshould be planned as early as possi ble, preferably within 7â€"14 days of successful stenting. Elective colonic resection would de crease the number of patients readmitted with recurrent obstruction due to stent migration, co lonic blockage,or diseaseprogression.…”

Section: Discussionmentioning

confidence: 67%

“…Esophageal stents have a smaller diameter of 10â€"20 mm and are less flexible. These limitations may ex plain the greater incidence of stent migration and blockage in previous studies [2,5,7]. Pre dilatation of the stricture or laser therapy [2] may also prevent the stricture from gripping the stent,resulting in stentmigration.…”

Section: Discussionmentioning

confidence: 99%

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Use of self-expanding metallic stents in the management of obstruction of the sigmoid colon.

Soonawalla

Thakur²,

Boorman³

et al. 1998

American Journal of Roentgenology

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Section: Discussioncontrasting

confidence: 74%

Section: Discussionmentioning

confidence: 67%

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Use of self-expanding metallic stents in the management of obstruction of the sigmoid colon.

Soonawalla

Thakur²,

Boorman³

et al. 1998

American Journal of Roentgenology

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“…Traditional management for patients who have either subtotal or complete malignant colon obstruction is associated with higher morbidity and mortality rates, reduced quality of life, and a need for a second operation (3,12). Preoperative stent insertion can avoid emergency operation with colostomy and enable elective one-stage surgery at a later point in time (12).…”

Section: Discussionmentioning

confidence: 99%

“…However, tumor ingrowth and stent migration have been reported as weaknesses in conventional single bare and covered stents, respectively (2)(3)(4). The use of bare stents has been hindered by progressive tumor ingrowth through the wire filaments of the bare stents and food residue or hard fecal impaction proximal to or at the level of the stent insertion site (5,6).…”

mentioning

confidence: 99%

Clinical effect of double coaxial self-expandable metallic stent in management of malignant colon obstruction

Won

Lee²,

Ku³

et al. 2015

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSEWe aimed to evaluate the clinical effectiveness and safety of double coaxial self-expandable metallic stent (DCSEMS) in management of malignant colonic obstruction as a bridge to surgery or palliation for inoperable patients. METHODSBetween April 2006 and December 2012, 49 patients (27 males and 22 females; median age, 68 years; age range, 38-91 years) were selected to receive decompressive therapy for malignant colonic obstruction by implanting a DCSEMS. Application of DCSEMS was attempted in 49 patients under fluoroscopic guidance. The obstruction was located in the transverse colon (n=2), descending colon (n=7), sigmoid colon (n=24), rectosigmoid junction (n=6), and the rectum (n=10). The intended use of DCSEMS was as a bridge to elective surgery in 23 patients and palliation in 26 patients. RESULTSClinical success, defined as >50% dilatation of the stent with subsequent symptomatic improvement, was achieved in 48 of 49 patients (98%). The stent was properly inserted in all patients. No immediate major procedure-related complications occurred. One patient in the bridge-to-surgery group had colon perforation three days after DCSEMS application. Four patients had late migrations of the double stent. CONCLUSION Application of DCSEMS is safe and effective in management of malignant colonic obstruction; it prevents stent migration and tumor ingrowth and lowers perforation rate during the stent application. F luoroscopic or endoscopic placement of either bare or covered expandable metallic stents was shown to be a safe, easy, and effective technique as a bridge to surgery and palliative treatment of colorectal cancer (1, 2). However, tumor ingrowth and stent migration have been reported as weaknesses in conventional single bare and covered stents, respectively (2-4). The use of bare stents has been hindered by progressive tumor ingrowth through the wire filaments of the bare stents and food residue or hard fecal impaction proximal to or at the level of the stent insertion site (5, 6). In contrast, the use of covered expandable metallic stents has been associated with stent migration (5, 7). To overcome the limitations associated with conventional bare and covered stents, a double coaxial self-expandable metallic stent (DCSEMS) has been developed to combine the strengths of bare and covered stents (7,8).The purpose of the present study was to report our experiences with fluoroscopic-guided placement of double stents in management of malignant colorectal obstruction as a bridge to surgery or palliative treatment. MethodsInformed consent was obtained from each patient and/or the legal guardian after the risks and benefits of the treatment were fully explained. Our Institutional Review Board approved this retrospective study. PatientsBetween April 2006 and December 2012, the images and clinical reports of 49 consecutive patients (27 males and 22 females; median age, 66 years; age range, 38-91 years) with malignant colorectal obstruction, who received decompressed therapy by DCSEMS implantation w...

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Experience With Endoluminal Colonic Wall Stents for the Management of Large Bowel Obstruction for Benign and Malignant Disease

Tamim

Ghellai²,

Counihan³

et al. 2000

Arch Surg

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Treatment of colonic obstruction with expandable metal stents: radiologic features.

Cited by 97 publications

References 16 publications

Use of self-expanding metallic stents in the management of obstruction of the sigmoid colon.

Use of self-expanding metallic stents in the management of obstruction of the sigmoid colon.

Clinical effect of double coaxial self-expandable metallic stent in management of malignant colon obstruction

Experience With Endoluminal Colonic Wall Stents for the Management of Large Bowel Obstruction for Benign and Malignant Disease

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