title: Endoluminal ultraflex stent for palliative treatment of malignant rectosigmoidal obstruction.
abstract: Rectosigmoidal obstruction due to a malignant tumor usually requires emergency surgical treatment, and colostomy is usually inevitable. This report describes our experience with the use of endoluminal self-expanding metallic stents in the treatment for rectosigmoidal obstruction in patients with unresectable recurrent colorectal cancer or intra-abdominal dissemination. A total of 5 cases were included (4 male and 1 female) with a mean age of 70.8 (range, 63-80) years. A self-expanding noncovered Ultraflex, 10 cm in length and 22 mm in diameter, was emplaced at the site of the obstruction under both endoscopic and fluoroscopic guidance. Each patient had a recurrent malignancy (colorectal cancer, 3; ovarian cancer, 1; gastric cancer, 1). No subsequent surgery was planned due to ascites or extensive intra-abdominal dissemination. There was no mortality related to the procedure. Immediate decompression with symptomatic relief was achieved. One stent later became obstructed due to tumor ingrowth, and in two cases there was intermittent bleeding from the tumor and these were treated by argon plasma coagulation (APC) endoscopically. The use of self-expanding Ultraflex stent provides good palliation for unresectable advanced tumors that cause left colonic obstruction.
authors.affiliation: Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. arakiyasumi@hkg.odn.ne.jp
authors.forename: Yasumi
authors.initials: Y
authors.lastname: Araki
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Sato
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kido
authors.forename: Shojiro
authors.initials: S
authors.lastname: Torigoe
authors.forename: Yukiya
authors.initials: Y
authors.lastname: Kishimoto
authors.forename: Takamasa
authors.initials: T
authors.lastname: Fukumitsu
authors.forename: Keiko
authors.initials: K
authors.lastname: Matono
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ogata
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shirouzu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012002:Rectal Diseases / Q000628:therapy*; D012810:Sigmoid Diseases / Q000628:therapy*; D015607:Stents