title: Endoscopic stenting as bridge-to-surgery (BTS) in left-sided obstructing colorectal cancer: Experience with conformable stents.
abstract: BACKGROUND
  Compared to emergency surgery, self-expandable metallic stents are effective and safe when used as bridge-to-surgery (BTS) in operable patients with acute colorectal cancer obstruction. In this study, we report data on the new conformable colonic stents.
  
  
  OBJECTIVE
  To evaluate clinical effectiveness of conformable stents as BTS in patients with acute colorectal cancer obstruction.
  
  
  METHODS
  This was a retrospective study.
  
  
  METHODS
  The study was conducted at six Italian Endoscopic Units.
  
  
  METHODS
  Data about patients with acute malignant colorectal obstruction were collected between 2007 and 2012.
  
  
  METHODS
  All patients were treated with conformable stents as BTS. Technical success, clinical success, rate of primary anastomosis and colostomy, early and late complications were evaluated.
  
  
  RESULTS
  Data about 88 patients (62 males) were reviewed in this study. Conformable SEMS were correctly deployed in 86 out of 88 patients, with resolution of obstruction in all treated patients. Tumor resection with primary anastomosis was possible in all patients. A temporary colostomy was performed in 40. Early complications did not occur. Late complications occurred in 11 patients. Stent migration was significantly higher in patients treated with partially-covered stents compared to the uncovered group (35% vs. 0%, P<0.001). Endoscopical re-intervention was required in 12% of patients. One patient with rectal cancer had an anastomotic dehiscence after surgery and he was successfully treated with endoscopic clipping. One year after surgery, all patients were alive and local recurrence have not been documented.
  
  
  CONCLUSIONS
  This was a retrospective and uncontrolled study.
  
  
  CONCLUSIONS
  Preliminary data from this large case series are encouraging, with a high rate of technical and clinical success and low rate of clinically relevant complications. Partially-covered SEMS should be avoided in order to reduce the risk of endoscopic re-intervention.
authors.affiliation: Department of Gastroenterology and Digestive Endoscopy, Ospedale Galliera, Genova, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Parodi
authors.affiliation: Department of Gastroenterology and Digestive Endoscopy, Ospedale di Sanremo, Sanremo, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: De Ceglie
authors.affiliation: Department of Gastroenterology and Digestive Endoscopy, Ospedali Riuniti Marche Nord, Pesaro, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: De Luca
authors.affiliation: Department of Gastroenterology and Digestive Endoscopy, Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Conigliaro
authors.affiliation: Surgical Endoscopy Unit, Ospedale Careggi, Firenze, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Naspetti
authors.affiliation: Department of Gastroenterology and Digestive Endoscopy, Ospedale S. Andrea, La Spezia, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Arpe
authors.affiliation: Department of Gastroenterology and Digestive Endoscopy, Ospedale Galliera, Genova, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Coccia
authors.affiliation: Department of Gastroenterology and Digestive Endoscopy, Ospedale di Sanremo, Sanremo, Italy. Electronic address: mxconio@tin.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Conio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D020099:Coated Materials, Biocompatible; D015179:Colorectal Neoplasms / Q000150:complications*; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents
chemical_list: D000497:Alloys; D020099:Coated Materials, Biocompatible; C013616:nitinol; D011138:Polytetrafluoroethylene