title: Preoperative colonoscopy through the colonic stent in patients with colorectal cancer obstruction.
abstract: OBJECTIVE
  To evaluate the feasibility of a preoperative colonoscopy through a self-expendable metallic stent (SEMS) and to identify the factors that affect complete colonoscopy.
  
  
  METHODS
  A total of 48 patients who had SEMS placement because of acute malignant colonic obstruction underwent preoperative colonoscopy. After effective SEMS placement, patients who showed complete resolution of radiological findings and clinical signs of acute colon obstruction underwent a standard bowel preparation. Preoperative colonoscopy was then performed using a standard colonoscope. If the passage of colonoscope was not feasible gastroscope was used. After colonoscopy, cecal intubation time, grade of bowel preparation, tumor location, stent location, presence of synchronous polyps or cancer, damage to colonoscopy and bleeding, and stent migration after colonoscopy were recorded.
  
  
  RESULTS
  Complete evaluation with colonoscope was possible in 30 patients (62.5%). In this group, adenoma was detected in 13 patients (43.3%). The factors that affected complete colonoscopy were also analyzed: Tumor location at an angle; stent placement at an angle; and stent expansion diameter, which affected complete colonoscopy significantly. However in multivariate analysis, stent expansion diameter was the only significant factor that affected complete colonoscopy. Complete evaluation using additional gastroscope was feasible in 42 patients (87.5%).
  
  
  CONCLUSIONS
  Preoperative colonoscopy through the colonic stent using only conventional colonoscope was unfavorable. The narrow expansion diameter of the stent may predict unfavorable outcome. In such a case, using small caliber scope should be considered and may expect successful outcome.
authors.affiliation: Jin Su Kim, Kang Moon Lee, Sang Woo Kim, Eun Jung Kim, Chul Hyun Lim, Seong Taek Oh, Myung Gyu Choi, Kyu Yong Choi, Division of Gastroenterology, Department of Internal Medicine, Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Jin Su
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Jin Su Kim, Kang Moon Lee, Sang Woo Kim, Eun Jung Kim, Chul Hyun Lim, Seong Taek Oh, Myung Gyu Choi, Kyu Yong Choi, Division of Gastroenterology, Department of Internal Medicine, Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Kang Moon
authors.initials: KM
authors.lastname: Lee
authors.affiliation: Jin Su Kim, Kang Moon Lee, Sang Woo Kim, Eun Jung Kim, Chul Hyun Lim, Seong Taek Oh, Myung Gyu Choi, Kyu Yong Choi, Division of Gastroenterology, Department of Internal Medicine, Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Jin Su Kim, Kang Moon Lee, Sang Woo Kim, Eun Jung Kim, Chul Hyun Lim, Seong Taek Oh, Myung Gyu Choi, Kyu Yong Choi, Division of Gastroenterology, Department of Internal Medicine, Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Jin Su Kim, Kang Moon Lee, Sang Woo Kim, Eun Jung Kim, Chul Hyun Lim, Seong Taek Oh, Myung Gyu Choi, Kyu Yong Choi, Division of Gastroenterology, Department of Internal Medicine, Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Chul Hyun
authors.initials: CH
authors.lastname: Lim
authors.affiliation: Jin Su Kim, Kang Moon Lee, Sang Woo Kim, Eun Jung Kim, Chul Hyun Lim, Seong Taek Oh, Myung Gyu Choi, Kyu Yong Choi, Division of Gastroenterology, Department of Internal Medicine, Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Seong Taek
authors.initials: ST
authors.lastname: Oh
authors.affiliation: Jin Su Kim, Kang Moon Lee, Sang Woo Kim, Eun Jung Kim, Chul Hyun Lim, Seong Taek Oh, Myung Gyu Choi, Kyu Yong Choi, Division of Gastroenterology, Department of Internal Medicine, Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Myung Gyu
authors.initials: MG
authors.lastname: Choi
authors.affiliation: Jin Su Kim, Kang Moon Lee, Sang Woo Kim, Eun Jung Kim, Chul Hyun Lim, Seong Taek Oh, Myung Gyu Choi, Kyu Yong Choi, Division of Gastroenterology, Department of Internal Medicine, Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Kyu Yong
authors.initials: KY
authors.lastname: Choi
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D000236:Adenoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D000368:Aged; D020685:Colonoscopes; D003113:Colonoscopy / Q000009:adverse effects / Q000295:instrumentation; D015179:Colorectal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D020699:Gastroscopes; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D008670:Metals; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D011474:Prosthesis Design; D012307:Risk Factors; D015607:Stents
chemical_list: D008670:Metals
keywords: Colon cancer; Complete colonoscopy; Preoperative colonoscopy; Stent