title: Endoscopic decompression of benign large bowel obstruction using a transanal drainage tube.
abstract: OBJECTIVE
  Endoscopic decompression of malignant colorectal obstruction is often dealt with using expandable metallic stents. Endoscopic decompression of benign large bowel obstruction is more difficult. We report the technique and outcome of transanal endoscopic decompression for benign large bowel obstruction.
  
  
  METHODS
  From January 2001 to June 2010, endoscopic decompression using a transanal drainage tube placement was attempted in consecutive patients with benign large bowel obstruction. The clinical features, technical success, complications, treatment after the tube placement and clinical success were retrospectively evaluated.
  
  
  RESULTS
  There were 13 patients (seven males, age 47-87, mean 69 years). The sites of obstruction were transverse colon [5 (38%)], sigmoid colon [3 (23%)], ileocecal valve [2 (15%)], splenic flexure [1 (8%)], descending colon [1 (8%)] and rectum [1 (8%)]. The most common cause of obstruction was anastomotic stricture [9 (69%)]. In 12 (92%) patients transanal decompression was technically successful with one perforation. An overtube, the reinsertion of colonoscope along the decompression tube, or the use of a small-diameter endoscope was required for the tube placement in seven (54%). In seven (54%) patients tube placement alone resulted in relief of bowel obstruction without operation.
  
  
  CONCLUSIONS
  Endoscopic decompression using a transanal drainage tube is effective for the management of benign large bowel obstruction.
authors.affiliation: Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan. horiuchi.akira@sihp.jp
authors.forename: A
authors.initials: A
authors.lastname: Horiuchi
authors.forename: Y
authors.initials: Y
authors.lastname: Nakayama
authors.forename: M
authors.initials: M
authors.lastname: Kajiyama
authors.forename: T
authors.initials: T
authors.lastname: Kamijima
authors.forename: N
authors.initials: N
authors.lastname: Kato
authors.forename: Y
authors.initials: Y
authors.lastname: Ichise
authors.forename: N
authors.initials: N
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000209:etiology / Q000628:therapy*; D003113:Colonoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D003251:Constriction, Pathologic / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies