[Self-expanding stent in obstructing colorectal cancer. A new technique to avoid abdominal surgery].
Emergency operations for obstructing colorectal cancer are associated with high morbidity and mortality rates and often result in a temporary or permanent colostomy. A colorectal stent can be used both for palliation and as a "bridge to surgery". Twenty-three patients with obstructive sigmoid or rectal cancer were selected for stenting. Self-expanding metal mesh stents were placed under endoscopic and flouroscopic guidance. Stent placement was technically successful in 19 patients and clinical success was seen in 18. There were only three minor complications, no major and no procedure related mortality. Four patients were later resected without a diverting stoma, two with rectal cancer had preoperative MRI and radiotherapy. In 15 patients the procedure was regarded as palliative. Stent migration was noted in four patients but symptomatic reobstruction did not occur, no patient needed later surgery. Colorectal stenting procedure is effective and safe and can be used in obstructing cancers both as a temporary relief before elective resection and as a definitive treatment in palliative cases.
Smedh
Kennet
K
Kolorektalsektionen, kirurgkliniken, Centrallasarettet, Västerås. kennet.smedh@ltvastmanland.se
Birgisson
Helgi
H
Raab
Yngve
Y
Strand
Eva
E
Karlsson
Catharina
C
D000368:Aged; D003113:Colonoscopy; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000150:complications / Q000601:surgery*; D012811:Sigmoid Neoplasms / Q000150:complications / Q000601:surgery*; D012812:Sigmoidoscopy; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome