Stents for colonic strictures: Materials,designs, and more |
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| Affiliation: | 1. Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada;2. Division of Cardiology, Case Western University, Cleveland, Ohio, USA;1. Gastroenterology Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;2. Im3D Medical Imaging Lab, Turin, Italy;3. Department of Surgical Sciences, University of Turin, Turin, Italy;4. Digestive Endoscopy Unit, Istituto Clinico Humanitas, Rozzano, Milan, Italy;5. Department of Gastroenterology, University Hospital L. Sacco, Milan, Italy;6. Endoscopy Division, European Institute of Oncology, Milan, Italy;7. Gastrointestinal Endoscopy Unit, Azienda Ospedaliera San Paolo, University of Milan, Milan, Italy;8. Gastroenterology and Endoscopy Unit, New S. Agostino Hospital, Modena, Italy;9. Division of Gastroenterology, Varese, Italy;10. Department of Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy;11. Unit of Digestive Endoscopy, Department of Surgery, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy;12. Endoscopy Unit, National Cancer Institute and G. Pascale Foundation, Naples, Italy;1. Division of Pathology, S.Orsola-Malpighi Hospital, Bologna, Italy;2. Gastroenterology Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;3. Gastroenterology and Endoscopy Unit, New S. Agostino Hospital, Modena, Italy;4. Endoscopy Division, European Institute of Oncology, Milan, Italy;5. Division of Colorectal Surgery, National Cancer Institute and G. Pascale Foundation, Naples, Italy;6. Division of Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy;7. Unit of Digestive Endoscopy, Department of Surgery, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy;8. Division of Pathology, S.Orsola-Malpighi Hospital, Bologna, Italy;9. Department of Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy;10. Division of Abdominal Medical Oncology, National Cancer Institute and G Pascale Foundation, Naples, Italy;1. Academic Department of Vascular Surgery, St Thomas’ Hospital, School of Cardiovascular Medicine and Sciences, King’s College London, London, UK;2. Department of Interventional Radiology, St Thomas’ Hospital, London, UK;1. Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong;2. Retraction Limited Company, Hong Kong;3. Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California, USA;4. Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Seoul, Korea;5. Department of Medicine, National University of Singapore, Singapore |
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| Abstract: | Colonic obstruction is one of the common manifestations of colon cancer. Historically, the treatment of malignant colonic obstruction consisted of surgical removal of the obstructing tumor, if possible, and decompression of the bowel with an ostomy. Self-expandable metal stents (SEMS) have now been used effectively for nonsurgical relief of malignant colonic obstruction, either for palliative care or as a bridge to elective surgery. Since the introduction of SEMS insertion technique in the early 1990s, multiple studies and reports have been published on the outcomes of SEMS in treating large bowel obstruction. SEMS are now recommended as an initial treatment of choice for acute left-sided colonic obstruction by surgical groups. SEMS insertion may be helpful to complete colonoscopy screening before surgery to detect any synchronous neoplasm proximal to a malignant colonic obstruction. SEMS insertion would also buy more time for a selected group of patients who may benefit from chemoradiation before surgery. This article reviews the development of colorectal stents, designs, materials, various types of colonic stents used in the treatment of colonic strictures, indications for their insertion, outcomes, limitations, complications, and future directions of the colonic stents. |
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| Keywords: | Stents Intestinal obstruction Colon cancer Colonic stricture SEMS Therapy Palliative care |
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