title: Self-expanding metallic stents drainage for acute proximal colon obstruction.
abstract: OBJECTIVE
  To clarify the usefulness of the self-expanding metallic stents (SEMS) in the management of acute proximal colon obstruction due to colon carcinoma before curative surgery.
  
  
  METHODS
  Eighty-one colon (proximal to spleen flex) carcinoma patients (47 males and 34 females, aged 18-94 years, mean = 66.2 years) treated between September 2004 and June 2010 for acute colon obstruction were enrolled to this study, and their clinical and radiological features were reviewed. After a cleaning enema was administered, urgent colonoscopy was performed. Subsequently, endoscopic decompression using SEMS placement was attempted.
  
  
  RESULTS
  Endoscopic decompression using SEMS placement was technically successful in 78 (96.3%) of 81 patients. Three patients' symptoms could not be relieved after SEMS placement and emergent operation was performed 1 d later. The site of obstruction was transverse colon in 18 patients, the hepatic flex in 42, and the ascending colon in 21. Following adequate cleansing of the colon, patients' abdominal girth was decreased from 88 ± 3 cm before drainage to 72 ± 6 cm 7 d later, and one-stage surgery after 8 ± 1 d (range, 7-10 d) was performed. No anastomotic leakage or postoperative stenosis occurred after operation.
  
  
  CONCLUSIONS
  SEMS placement is effective and safe in the management of acute proximal colon obstruction due to colon carcinoma, and is considered as a bridged method before curative surgery.
authors.affiliation: Department of Endoscopic Center, Zhongshan Hospital, Fudan University Medical Center, Shanghai 200032, China.
authors.forename: Li-Qin
authors.initials: LQ
authors.lastname: Yao
authors.forename: Yun-Shi
authors.initials: YS
authors.lastname: Zhong
authors.forename: Mei-Dong
authors.initials: MD
authors.lastname: Xu
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Xu
authors.forename: Ping-Hong
authors.initials: PH
authors.lastname: Zhou
authors.forename: Xian-Li
authors.initials: XL
authors.lastname: Cai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology* / Q000601:surgery*; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D003113:Colonoscopy; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D055815:Young Adult