Ultraflex precision colonic stent placement as a bridge to surgery in patients with malignant colon obstruction

Fregonese, Diego; Naspetti, Riccardo; Ferrer, Salvador; Gállego, José Antonio Gutiérrez; Costamagna, Guido; Dumas, R; Campaioli, M.; Morante, Alfredo Lopez; Mambrini, P.; Meisner, Søren; Repici, Alessandro; Andreo, Luis; Masci, E.; Mingo, Alberto; Barcenilla, José María; Petruzziello, Lucio

doi:10.1016/j.gie.2007.05.022

Cited by 49 publications

(20 citation statements)

References 30 publications

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“…A large number of dedicated colonic SEMS are currently available [8,15,16] ( table 2 ). The ideal SEMS would be with a small-diameter delivery system easy to insert through the colonoscope, flexible enough to conform curvatures and with a strong expansible force to expand to the caliber of the colon [17,18] .…”

Section: Brief Aspect On Current Techniquesmentioning

confidence: 99%

Colonic Stents for the Palliation of Malignant Colonic Obstruction

Štimac

2008

Dig Dis

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Colorectal self-expanding metal stents have revolutionized the palliative treatment of patients with advanced malignancies and those patients who present with acute colon obstruction and who were previously treated with emergent surgical decompression via formation of colostomy. The placement of stents can be fluoroscopically or non-fluoroscopically guided. The use of stents is associated with significant reduction in hospital duration, mortality and medical complications compared to surgery. The most frequent complications are stent malposition and migration, bleeding, colonic perforation and tumor ingrowth and/or overgrowth.

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Section: Brief Aspect On Current Techniquesmentioning

confidence: 99%

Colonic Stents for the Palliation of Malignant Colonic Obstruction

Štimac

2008

Dig Dis

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“…Unfortunately, a long-awaited prospective randomized multicenter trial had to be prematurely closed because of complications, presumably related to the use of a large (30 mm) nitinol stent [22,23]. Other studies using SEMS as a bridge to surgery have shown technical success rates of 83-97% and avoided emergency surgery in 70-94% of patients [24,25].…”

Section: Extracolonic Malignant Obstructionmentioning

confidence: 99%

Update on the Indications and Use of Colonic Stents

Bonin

Baron

2010

Curr Gastroenterol Rep

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Self-expandable metal stent (SEMS) placement is a minimally invasive option for achieving acute colonic decompression in obstructed colorectal cancer. Colorectal stenting offers nonoperative, immediate, and effective colon decompression and allows bowel preparation for an elective oncologic resection. Patients who benefit the most are highrisk surgical patients and candidates for laparoscopic resection with complete obstruction, because emergency surgery can be avoided in more than 90% of patients. Colonic stent placement also offers effective palliation of malignant colonic obstruction, although it carries risks of delayed complications. When performed by experienced endoscopists, the technical success rate is high with a low procedural complication rate. Despite concerns of tumor seeding following endoscopic colorectal stent placement, no difference exists in oncologic long-term survival between patients who undergo stent placement followed by elective resection and those undergoing emergency bowel resection. Colorectal stents have also been used in selected patients with benign colonic strictures. Uncovered metal stents should be avoided in these patients, and fully covered stents are associated with high risk of migration. Patients with benign colonic stricture with acute colonic obstruction who are at high risk for emergency surgery can gain temporary relief of obstruction after SEMS placement; the stent can be removed en bloc with the colon specimen at surgery. This article reviews the techniques and indications of SEMS placement for benign and malignant colorectal obstructions.

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“…Despite the varying advantages of the different sized guidewires, the 0.035 00 guidewire has been overwhelmingly used in reports of gastroduodenal and colorectal stent placement procedures [2][3][4][5][6][7][8][9][10]16]. This is likely due to the belief that the stability of the 0.035 00 guidewire provides superior ease and accuracy of stent placement.…”

Section: Introductionmentioning

confidence: 99%