title: WallFlex colonic stent placement for management of malignant colonic obstruction: a prospective study at two centers.
abstract: BACKGROUND
  Self-expanding metal stents (SEMSs) can alleviate malignant colonic obstruction and avoid emergency decompressive surgery. The use of colonic larger-diameter SEMSs may improve bowel function and reduce migration risk.
  
  
  OBJECTIVE
  To evaluate the effectiveness and safety of a novel large-diameter SEMS (WallFlex) designed for delivery through the endoscope in treating malignant colonic obstruction.
  
  
  METHODS
  Prospective clinical cohort study.
  
  
  METHODS
  Two Italian study centers.
  
  
  METHODS
  Forty-two consecutive patients with malignant colonic obstruction: 23 requiring palliation and 19 bridging to surgery.
  
  
  METHODS
  Colorectal SEMS placement.
  
  
  METHODS
  Technical success, defined as accurate SEMS deployment across the stricture on the first attempt; clinical success, ie, complete relief of bowel obstruction without complications; and bridging to surgery, denoting the performance of elective one-stage surgery.
  
  
  RESULTS
  The rate of technical success was 93% (95% CI, 81%-99%) and of initial clinical success was 95% (95% CI, 84%-99%). In 58% (95% CI, 40%-84%) of the palliation group, clinical success was maintained after 6 months. All 19 patients with operable tumors were successfully bridged to one-stage elective surgery within a median of 5 days. One perforation and one stent migration occurred. All complications could be resolved nonsurgically.
  
  
  CONCLUSIONS
  No control group was included.
  
  
  CONCLUSIONS
  In a prospective study of through-the-scope WallFlex stent placement for malignant colonic obstruction, high rates of technical and initial clinical success, and bridging to surgery were achieved. Complications could be readily managed.
authors.affiliation: Milano, Bologna, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Repici
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Caro
authors.forename: Carmelo
authors.initials: C
authors.lastname: Luigiano
authors.forename: Carlo
authors.initials: C
authors.lastname: Fabbri
authors.forename: Nico
authors.initials: N
authors.lastname: Pagano
authors.forename: Paoletta
authors.initials: P
authors.lastname: Preatoni
authors.forename: Silvio
authors.initials: S
authors.lastname: Danese
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fuccio
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fucci
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Consolo
authors.forename: Alberto
authors.initials: A
authors.lastname: Malesci
authors.forename: Nicola
authors.initials: N
authors.lastname: D'Imperio
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cennamo
mesh_terms: D000230:Adenocarcinoma / Q000150:complications; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D012809:Colon, Sigmoid / Q000473:pathology; D003110:Colonic Neoplasms / Q000150:complications; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D012810:Sigmoid Diseases / Q000209:etiology / Q000628:therapy*; D015607:Stents
chemical_list: D000497:Alloys; C013616:nitinol