Preoperative colonoscopy after self-expandable metallic stent placement in patients with acute neoplastic colon obstruction.
BACKGROUND
In patients with colorectal cancer, a preoperative colonoscopy is recommended to exclude synchronous lesions. Unfortunately, between 7% and 29% of patients with colorectal cancer present with acute colonic obstruction, making complete colonoscopy impossible.


OBJECTIVE
The aim of our study was to evaluate the feasibility of a preoperative colonoscopy after effective stent placement in patients with acute neoplastic obstruction.


METHODS
Single-center prospective study.


METHODS
All examinations were carried out at a tertiary referral center with 24-hour emergency endoscopy service.


METHODS
Fifty-seven patients with acute neoplastic colon obstruction.


METHODS
Patients who recovered from an acute colon obstruction by an effective stent placement and who had a resectable cancer underwent a preoperative colonoscopy.


METHODS
Patients with a resectable cancer, complete preoperative colonoscopies, and synchronous lesions rates.


RESULTS
Self-expandable metallic stents (SEMS) were placed in 50 of 57 patients (87.8%). Thirty-one of 50 patients had a resectable cancer (62%), and a complete preoperative colonoscopy was possible in 29 of 31 patients (93.4%). A synchronous cancer was detected in 3 patients (9.6%), changing the surgical plan.


CONCLUSIONS
Seven patients in whom the SEMS placement (12.2%) was unsuccessful underwent an urgent surgical intervention. Nineteen of 50 patients who had stent placement were not eligible for our study because of unresectable cancer.


CONCLUSIONS
Our study indicates that it is feasible in a majority of patients to perform full preoperative colonoscopy after relief of acute colonic obstruction with SEMS before surgical resection.
Vitale
Mario A
MA
Gastroenterology and Endoscopy Unit, San Giovanni-Addolorata-Calvary Hospital, Rome, Italy.
Villotti
Giuseppe
G
d'Alba
Lucia
L
Frontespezi
Stefano
S
Iacopini
Federico
F
Iacopini
Giampaolo
G
D000208:Acute Disease; D000236:Adenoma / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000209:etiology; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis*; D011300:Preoperative Care; D011446:Prospective Studies; D011474:Prosthesis Design; D015607:Stents