title: Ultraflex precision colonic stent placement as a bridge to surgery in patients with malignant colon obstruction.
abstract: BACKGROUND
  Emergency surgery for malignant colon obstruction entails relatively high morbidity and mortality rates and typically necessitates a 2-step resection. These problems might be potentially mitigated by placement of a self-expanding metal stent (SEMS) as a bridge to surgery. A nitinol colorectal SEMS may offer several advantages, but available evidence on the utility of this SEMS type remains highly limited.
  
  
  OBJECTIVE
  Our purpose was to evaluate the effectiveness and safety as a bridge to surgery of a nitinol SEMS designed for colorectal use.
  
  
  METHODS
  Prospective and retrospective multicenter clinical study.
  
  
  METHODS
  Sixteen European study centers.
  
  
  METHODS
  Thirty-six patients with malignant colonic obstruction.
  
  
  METHODS
  Nitinol colorectal SEMS placement.
  
  
  METHODS
  Technical success in accurate SEMS placement with coverage of the entire stricture length, clinical success in alleviating colonic obstructive symptoms, and bridging to elective surgery.
  
  
  RESULTS
  Technical success was achieved in 97% of patients with a 95% CI of 85% to 100% and clinical success in 81% (95% CI, 64%-92%). Elective surgery was performed in 94% (95% CI, 81%-99%) of patients at a median of 11 days (95% CI, 7-15 days) after SEMS placement. SEMS-related perforation occurred in 3 patients.
  
  
  CONCLUSIONS
  No control group was included in this nonrandomized cohort study.
  
  
  CONCLUSIONS
  In this first comparatively large clinical study of a nitinol colorectal SEMS as a bridge to surgery, a high proportion of patients successfully proceeded to elective surgery after prior decompression by SEMS placement.
authors.affiliation: Camposampiero, Firenze, Rome, Prato, Torino, Milan, Italy, Valencia, Madrid, Burgos, Alicante, Palencia, Spain, Nice, Ajaccio, France, Copenhagen, Denmark.
authors.forename: Diego
authors.initials: D
authors.lastname: Fregonese
authors.forename: Riccardo
authors.initials: R
authors.lastname: Naspetti
authors.forename: Salvador
authors.initials: S
authors.lastname: Ferrer
authors.forename: Juan
authors.initials: J
authors.lastname: Gallego
authors.forename: Guido
authors.initials: G
authors.lastname: Costamagna
authors.forename: Remi
authors.initials: R
authors.lastname: Dumas
authors.forename: Marcello
authors.initials: M
authors.lastname: Campaioli
authors.forename: Alfredo Lopez
authors.initials: AL
authors.lastname: Morante
authors.forename: Pierre
authors.initials: P
authors.lastname: Mambrini
authors.forename: Søren
authors.initials: S
authors.lastname: Meisner
authors.forename: Alessandro
authors.initials: A
authors.lastname: Repici
authors.forename: Luis
authors.initials: L
authors.lastname: Andreo
authors.forename: Enzo
authors.initials: E
authors.lastname: Masci
authors.forename: Alberto
authors.initials: A
authors.lastname: Mingo
authors.forename: Javier
authors.initials: J
authors.lastname: Barcenilla
authors.forename: Lucio
authors.initials: L
authors.lastname: Petruzziello
mesh_terms: D000230:Adenocarcinoma / Q000150:complications; D000328:Adult; D000497:Alloys; D003110:Colonic Neoplasms / Q000150:complications; D019299:Decompression, Surgical / Q000379:methods; D004378:Duodenal Diseases / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D015607:Stents
chemical_list: D000497:Alloys; C013616:nitinol