Endoscopy 2010; 42(2): 163-168
DOI: 10.1055/s-0029-1243881
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© Georg Thieme Verlag KG Stuttgart · New York

Colonic stenting: a palliative measure only or a bridge to surgery?

T.  H.  Baron1
  • 1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
Further Information

Publication History

submitted 25 September 2009

accepted after revision 16 October 2009

Publication Date:
05 February 2010 (online)

Self-expandable metal stents (SEMS) are used to relieve malignant luminal obstruction throughout the gastrointestinal tract. Colonic SEMS are used most often for palliation of obstruction in nonoperative candidates or in patients with advanced disease. The other indication for colonic stent placement is as a preoperative modality for the relief of acute obstruction so that resection can be done on an elective basis after stabilization of the acute illness and bowel preparation. For both of these indications, the goal is avoidance of a temporary or permanent ostomy. In this manuscript the supporting data for each of these indications will be reviewed.

References

  • 1 Sebastian S, Johnston S, Geoghegan T. et al . Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction.  Am J Gastroenterol. 2004;  99 2051-2057
  • 2 Van Hooft J E, Fockens P, Marinelli A W. et al. and Dutch Colorectal Stent Group . Early closure of a multicenter randomized clinical trial of endoscopic stenting versus surgery for stage IV left-sided colorectal cancer.  Endoscopy. 2008;  40 184-191
  • 3 Repici A, De Caro G, Luigiano C. et al . WallFlex colonic stent placement for management of malignant colonic obstruction: a prospective study at two centers.  Gastrointest Endosc. 2008;  67 77-84
  • 4 Faragher I G, Chaitowitz I M, Stupart D A. Long-term results of palliative stenting or surgery for incurable obstructing colon cancer.  Colorectal Dis. 2008;  10 668-672
  • 5 Cennamo V, Fuccio L, Mutri V. et al . Does stent placement for advanced colon cancer increase the risk of perforation during bevacizumab-based therapy?.  Clin Gastroenterol Hepatol. 2009;  Jul 21. [Epub ahead of print]
  • 6 Van Hooft J E, Bemelman W A, Breumelhof R. et al . Colonic stenting as bridge to surgery versus emergency surgery for management of acute left-sided malignant colonic obstruction: a multicenter randomized trial (Stent-in 2 study).  BMC Surg. 2007;  7 12
  • 7 Fregonese D, Naspetti R, Ferrer S. et al . Ultraflex precision colonic stent placement as a bridge to surgery in patients with malignant colon obstruction.  Gastrointest Endosc. 2008;  67 68-73
  • 8 Brehant O, Fuks D, Bartoli E. et al . Elective (planned) colectomy in patients with colorectal obstruction after placement of a self-expanding metallic stent as a bridge to surgery: the results of a prospective study.  Colorect Dis. 2009;  11 178-183
  • 9 Park I J, Choi G S, Kang B M. et al . Comparison of one-stage managements of obstructing left-sided colon and rectal cancer: stent-laparoscopic approach vs. intraoperative colonic lavage.  J Gastrointest Surg. 2009;  13 960-965
  • 10 Repici A, Adler D G, Gibbs C M. et al . Stenting of the proximal colon in patients with malignant large bowel obstruction: techniques and outcomes.  Gastrointest Endosc. 2007;  66 940-944
  • 11 Kim J S, Hur H, Min B S. et al . Oncologic outcomes of self-expanding metallic stent insertion as a bridge to surgery in the management of left-sided colon cancer obstruction: comparison with nonobstructing elective surgery.  World J Surg. 2009;  33 1281-1286

T. H. BaronMD 

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester

200 First Street SW, Charlton 8A
Rochester, MN 55905
USA

Fax: +1-507-266-3939

Email: baron.todd@mayo.edu

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