title: Elective (planned) colectomy in patients with colorectal obstruction after placement of a self-expanding metallic stent as a bridge to surgery: the results of a prospective study.
abstract: BACKGROUND
  Acute malignant colorectal obstruction (CRO) can be satisfactorily dealt by the placement of a self-expanding metallic stent (SEMS). The aim of this prospective study was to evaluate the rate of elective (planned) colectomy (EPC) in patients with CRO after SEMS placement as a bridge to surgery on an intention-to-treat (ITT) basis.
  
  
  METHODS
  From 2002 to 2007, 30 SEMS were placed as a bridge to surgery in 30 CRO patients (median age 73 +/- 12 years). The obstructing lesions were located in the right (n = 1), transverse (n = 1) or left colon (n = 24) or the upper third of the rectum (n = 4).
  
  
  RESULTS
  The SEMS was placed successfully in 25 (83%) patients. Five patients underwent Hartmann's procedure (n = 2) or a diverting colostomy (n = 3). The SEMS was functionally operational in 23 (92%) of the 25 patients. A diverting colostomy was avoided in 23 (77%) of the 30 patients (placement failure n = 5, clinical failure n = 2). There were no complications in 17 (80%) patients. On an ITT basis, 70% of the patients (21 out of 30) underwent an EPC.
  
  
  CONCLUSIONS
  On an ITT basis, SEMS placement in CRO patients enabled EPC in 70% of patients.
authors.affiliation: Federation of Digestive Diseases, Amiens North Hospital, University of Picardy Jules Verne, Amiens Cedex 01, France.
authors.forename: O
authors.initials: O
authors.lastname: Brehant
authors.forename: D
authors.initials: D
authors.lastname: Fuks
authors.forename: E
authors.initials: E
authors.lastname: Bartoli
authors.forename: T
authors.initials: T
authors.lastname: Yzet
authors.forename: P
authors.initials: P
authors.lastname: Verhaeghe
authors.forename: J M
authors.initials: JM
authors.lastname: Regimbeau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000150:complications / Q000601:surgery*; D003251:Constriction, Pathologic / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods; D015607:Stents