Management of acute malignant large-bowel obstruction with self-expanding metal stent |
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Authors: | S Mucci-Hennekinne A G Kervegant N Regenet A Beaulieu J P Barbieux N Dehni C Casa J P Arnaud |
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Institution: | (1) Department of Visceral Surgery, CHU-Angers, 4 rue Larrey, Angers-49100, France |
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Abstract: | Background Colorectal stents are being used for palliation and as a “bridge to surgery” in obstructing colorectal carcinoma. The purpose
of this study was to review our experience with self-expanding metal stents (SEMS) as the initial interventional approach
in the management of acute malignant large bowel obstruction.
Methods Between February 2002 and May 2006, 67 patients underwent the insertion of a SEMS for an obstructing malignant lesion of the
left-sided colon or rectum.
Results In 55 patients, the stents were placed for palliation, whereas in 12 they were placed as a bridge to surgery. Stent placement
was technically successful in 92.5% (n = 62), with a clinical success rate of 88% (n = 59). Two perforations that occurred during stent placement we retreated by an emergency Hartmann operation. In intention-to-treat
by stent, the peri-interventional mortality was 6% (4/67). Stent migration was reported in 3 cases (5%), and stent obstruction
occurred in 8 cases (13.5%). Of the nine patients with stents successfully placed as a bridge to surgery, all underwent elective
single-stage operations with no death or anastomotic complication.
Conclusions Stent insertion provided an effective outcome in patients with malignant colonic obstruction as a palliative and preoperative
therapy. |
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Keywords: | Colonic obstruction Stent Endoprosthesis Cancer Colorectal |
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