[Management of the neoplastic stenosis of the left colon with self-expandable endoprosthesis].
Malignant tumors of the large bowel develop colonic obstruction in 10-30% cases. Recently many authors have employed self-expandable stents to resolve the colonic obstruction. During 2002, seven patients affected by neoplastic malignant stenosis of the left colon underwent endoscopic placement of self-expandable enteral stent. The technique succeeded in relieving the obstruction in 6 patients, while in a woman affected by malignant tumor of the splenic flexure, colonic stenting was unsuccessful. The Authors didn't observe any procedure related complications; sign and symptoms of intestinal obstruction resolved within 24-72 hours from placement. Four patients needed hydro-electrolitemic correction, intestinal cleaning and R0 resection with one stage anastomosis within 5 and 9 days. Bowel decompression of the neoplastic stenosis relieved by self expandable metallic stents is useful to avoid emergency surgery and provide time for a complete preoperative staging, a metabolic correction and a mechanical bowel preparation. Complications of stent placement are common in many reports and include minor rectal bleeding (2%) and perforations (4%). Stenting is contraindicated in cases of enlarged colon with diameter superior to 8 cm or in flogistic lesions.
Corsale
I
I
USL 3 Regione Toscana - Ospedale SS. Cosma e Damiano di Pescia (PT), U.O. Chirurgia Generale.
Foglia
E
E
Mandato
M
M
Aloise
F
F
Rigutini
M
M
Bartolomei
M
M
D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology* / Q000601:surgery*; D003110:Colonic Neoplasms / Q000150:complications / Q000601:surgery*; D003251:Constriction, Pathologic / Q000601:surgery; D004867:Equipment Design; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000009:adverse effects