title: Preoperative colonoscopy after self-expandable metallic stent placement in patients with acute neoplastic colon obstruction.
abstract: 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.
authors.affiliation: Gastroenterology and Endoscopy Unit, San Giovanni-Addolorata-Calvary Hospital, Rome, Italy.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Vitale
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Villotti
authors.forename: Lucia
authors.initials: L
authors.lastname: d'Alba
authors.forename: Stefano
authors.initials: S
authors.lastname: Frontespezi
authors.forename: Federico
authors.initials: F
authors.lastname: Iacopini
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Iacopini
mesh_terms: 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