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https://www.readbyqxmd.com/read/29091349/randomised-controlled-trial-of-colonic-stent-insertion-in-non-curable-large-bowel-obstruction-a-post-hoc-cost-analysis
#1
Christopher J Young, Assad Zahid
AIM: With the increasing burden on the health care system, this study aims to perform a cost-effectiveness analysis on the management of incurable large bowel obstruction comparing the cost of a stent versus surgery. METHOD: A prospective randomised controlled trial was conducted at two major teaching hospitals in Australia between September 2006 and November 2011. 56 patients with malignant incurable large bowel obstruction were randomised to stent insertion or surgical decompression, of whom 52 were included in the final analysis...
November 1, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29045026/feasibility-of-laparoscopic-surgery-after-stent-insertion-for-obstructive-colorectal-cancer
#2
Hideharu Shimizu, Ryoto Yamazaki, Hideo Ohtsuka, Itaru Osaka, Kunio Takuma, Yasuhiro Morita
INTRODUCTION: A growing number of patients with obstructive colorectal cancer are being treated with self-expanding metallic stents (SEMS) followed by laparoscopic resection. The aim of this study was to assess the feasibility of stent insertion and laparoscopic surgery for obstructive colorectal cancer and to compare these outcomes to regular laparoscopic surgery for non-obstructive colorectal cancer. METHODS: We retrospectively analyzed the outcomes of patients with a malignant colonic obstruction who underwent SEMS placement followed by elective laparoscopic resection...
October 17, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28957966/management-of-colorectal-cancer-patients-undergoing-a-colonic-stenting-a-multidisciplinary-team-approach
#3
Bejo Utomo, Carmen Alvarez, Ricardo F Baldonedo
Colonic stent procedure is one of the best therapeutic medical interventions for managing a colorectal cancer patient with large bowel obstruction. This is a retrospective study that evaluated data from the past 10 years; it examined the epidemiological and clinical data of patients with colorectal cancer undergoing a colonic stent procedure. In addition, this study prospectively evaluated the nurse's roles during a colonic stent procedure, and at the same time, it explored the patient's satisfaction with the procedure at the Hospital Universitario Central de Asturias (Spain)...
September 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28826546/does-short-term-morbidity-and-stoma-reduction-outweigh-a%C3%A2-potential-long-term-risk-of-colonic-stent-placement
#4
EDITORIAL
Emo E van Halsema, Jeanin E van Hooft
No abstract text is available yet for this article.
September 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28810253/outcomes-of-self-expanding-metal-stents-in-malignant-colonic-obstruction-are-independent-of-location-or-length-of-the-stenosis-results-of-a-retrospective-single-center-series
#5
Paul K Schoonbeek, Pim Genzel, Eline H van den Berg, O Aart van Dobbenburgh, Frank Ter Borg
AIM: To evaluate the length and location of stenosis in the colon as predictors of technical and clinical outcomes of stent placement in patients presenting with obstructive colorectal cancer. METHODS: A prospective single-center cohort study of patients treated with a colonic stent for malignant obstruction, regardless of stenosis length or location. Stenosis length was assessed globally on the appropriate CT slice as well as by 3D CT reconstruction. We analyzed whether outcomes were different in patients with a right sided-tumor and/or a stenosis >4 cm long...
August 16, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28791424/-to-stent-or-not-to-stent-immediate-emergency-surgery-with-laparoscopic-radical-colectomy-with-cme-and-primary-anastomosis-is-feasible-for-obstructing-left-colon-carcinoma
#6
Salomone Di Saverio, Arianna Birindelli, Edoardo Segalini, Matteo Novello, Anna Larocca, Francesco Ferrara, Gian Andrea Binda, Marco Bassi
Great debate exists in the initial acute management of large bowel obstruction from obstructing left colon carcinoma. While endoscopic stenting is well established as the first approach in the setting of palliative care of patients with advanced metastatic disease as well as a bridge to elective surgery in elderly patients who have an increased risk of postoperative mortality (age >70 years and/or ASA status ≥3), controversies exist regarding oncological safety and long-term outcomes of endoscopic colonic stenting in younger patients and ESGE Guidelines do not recommend SEMS placement in patients <70 and fit for curative surgery...
August 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28761765/endoscopic-stenting-as-bridge-to-surgery-versus-emergency-resection-for-left-sided-malignant-colorectal-obstruction-an-updated-meta-analysis
#7
REVIEW
Niccolò Allievi, Marco Ceresoli, Paola Fugazzola, Giulia Montori, Federico Coccolini, Luca Ansaloni
INTRODUCTION: Emergency resection represents the traditional treatment for left-sided malignant obstruction. However, the placement of self-expanding metallic stents and delayed surgery has been proposed as an alternative approach. The aim of the current meta-analysis was to review the available evidence, with particular interest for the short-term outcomes, including a recent multicentre RCT. METHODS: We considered randomized controlled trials comparing stenting as a bridge to surgery and emergency surgery for the management of left-sided malignant large bowel obstruction, performing a systematic review in MEDLINE, PubMed database, and the Cochrane libraries...
2017: International Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28579348/ten-year-survival-after-endoscopic-stent-placement-as-a-bridge-to-surgery-in-obstructing-colon-cancer
#8
Bram Verstockt, Annelien Van Driessche, Marc De Man, Pieter van der Spek, Koen Hendrickx, Veerle Casneuf, Pieter Dobbels, Yves Van Molhem, Jo Vandervoort
BACKGROUND AND AIMS: Self-expandable metal stents are used increasingly in the treatment of obstructing colorectal cancer (CRC). Although endoscopic colon stenting is widely accepted in palliation, disagreement exists about its role in a curative setting. This study aims to describe long-term survival data in a large patient group treated with colon stenting as a bridge to surgery for CRC. METHODS: This prospective study included 97 patients who presented in a Belgian hospital between 1998 and 2013 with obstructing, although potentially curable, CRC...
June 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28569279/safety-and-efficacy-of-self-expandable-metal-stents-for-obstructive-proximal-and-distal-large-bowel-cancer
#9
V Mitra, M Hu, D Majumdar, V Krishnan, B Chaudhury, J Hancock, D Dwarakanath
Self-expandable metal stents are often used to treat obstructive large bowel cancers. This study assessed the safety and efficacy of colonic stent insertion carried out in a district general hospital. Methods A retrospective review was carried out between 1 January 2007 and 28 February 2014 to identify patients who underwent stent insertion for malignant colorectal obstruction. Results Seventy-five patients (median age 75.2 years, 70.6% male) with primary colorectal cancer underwent stent insertion - 53 underwent semi-elective self-expanded metal stent insertion (for subacute bowel obstruction) and 22 had emergency stent inserted (for acute bowel obstruction)...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28567379/colonic-obstruction-caused-by-video-capsule-entrapment-in-a-metal-stent
#10
Ervin Toth, Lars Marthinsen, Maria Bergström, Per-Ola Park, Peter Månsson, Artur Nemeth, Gabriele Wurm Johansson, Henrik Thorlacius
Video capsule endoscopy (VCE) has become the method of choice for visualizing the small bowel mucosa and is generally considered to be a safe method. Although uncommon, the most feared complication of VCE is capsule retention that can potentially lead to life-threatening bowel obstruction. Herein, we present for the first time a case of capsule retention in a colonic stent. The patient had known Crohn's disease with colonic involvement and underwent an uneventful but incomplete small bowel VCE for assessment of disease activity and extension for optimizing medical treatment...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28501253/resection-of-the-primary-tumor-in-stage-iv-colorectal-cancer-when-is-it-necessary
#11
REVIEW
Leandro Feo, Michael Polcino, Garrett M Nash
Management of metastatic colorectal cancer requires accurate staging and multidisciplinary evaluation, leading to a consensus treatment plan with the ultimate goal of increasing survival and improving the quality of life, while taking into consideration the patient's performance status, disease burden, and goals of care. Since the introduction of multidrug chemotherapeutic regimens, survival of patients with metastatic colorectal cancer has improved. Many patients with unresectable disease are undergoing surgery for asymptomatic primary tumors despite evidence that it is usually a futile intervention...
June 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28392363/stent-as-bridge-to-surgery-for-left-sided-malignant-colonic-obstruction-reduces-adverse-events-and-stoma-rate-compared%C3%A2-with-emergency-surgery-results-of-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
REVIEW
Alberto Arezzo, Roberto Passera, Giacomo Lo Secco, Mauro Verra, Marco Augusto Bonino, Eduardo Targarona, Mario Morino
BACKGROUND AND AIMS: Twenty years after the first description of the technique, the debate is still open on the role of self-expandable metallic stent (SEMS) placement as a bridge to elective surgery for symptomatic left-sided malignant colonic obstruction. The aim was to compare morbidity rates after colonic stenting bridge to surgery (SBTS) versus emergency surgery (ES) for left-sided malignant obstruction. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) on SBTS or ES for acute symptomatic malignant left-sided large bowel obstruction...
September 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28367495/long-term-outcomes-of-palliative-colonic-stenting-versus-emergency-surgery-for-acute-proximal-malignant-colonic-obstruction-a-multicenter-trial
#13
Ali Siddiqui, Natalie Cosgrove, Linda H Yan, Daniel Brandt, Raymond Janowski, Ankush Kalra, Tingting Zhan, Todd H Baron, Allesandro Repici, Linda Jo Taylor, Douglas G Adler
Background and study aims Long-term data are limited regarding clinical outcomes of self-expanding metal stents as an alternative for surgery in the treatment of acute proximal MBO. The aim of this study was to compare the long-term outcomes of stenting to surgery for palliation in patients with incurable obstructive CRC for lesions proximal to the splenic flexure. Patients and methods Retrospective multicenter cohort study of obstructing proximal CRC patients with who underwent insertion of a SEMS (n = 69) or surgery (n = 36) from 1999 to 2014...
April 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28365542/a-methodology-for-the-customized-design-of-colonic-stents-based-on-a-parametric-model
#14
S Puértolas, D Navallas, A Herrera, E López, J Millastre, E Ibarz, S Gabarre, J A Puértolas, L Gracia
The choice of necessary stent properties depends mainly on the length of the stenosis and degree of occlusion. So a stent design with variable radial stiffness along its longitudinal axis would be a good option. The design proposed corresponds to a tube-based stent with closed diamond-shaped cells made from a NiTi alloy. By acting independently on different geometric factors, variable geometries can be obtained with different radial force reactions. A design adjustment according to specific requirements, in order to get a better fit to ill-duct and reduces complications, is possible...
March 27, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28299628/management-of-colon-stents-based-on-bernoulli-s-principle
#15
Yoshiharu Uno
BACKGROUND AND AIMS: The colonic self-expanding metal stent (SEMS) has been widely used for "bridge to surgery" and palliative therapy. However, if the spread of SEMS is insufficient, not only can a decompression effect not be obtained but also perforation and obstructive colitis can occur. The mechanism of occurrence of obstructive colitis and perforation was investigated by flow dynamics. METHODS: Bernoulli's principle was applied, assuming that the cause of inflammation and perforation represented the pressure difference in the proximal lumen and stent...
March 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28133331/-a-case-of-malignant-obstruction-of-the-colon-due-to-peritoneal-dissemination-of-gastric-carcinoma-treated-with-colon-stenting-and-colectomy-after-chemotherapy
#16
Takashi Kanazawa, Motoki Ninomiya, Yasuhiro Choda, Michihiro Ishida, Soichiro Miyake, Daisuke Satoh, Noriaki Tokumoto, Masao Harano, Hiroyoshi Matsukawa, Yasutomo Ojima, Hitoshi Idani, Shigehiro Shiozaki, Masazumi Okajima
A man in his 60s underwent gastrectomy to treat gastric carcinoma. Approximately 2.5 years after the surgery, he was admitted to the hospital because of abdominal pain. He was diagnosed with obstruction of the transverse colon due to a colon tumor. A stent was placed to treat the obstruction and avoid oncologic emergency. Biopsy results and imaging showed that the patient did not have colon cancer, but his previous gastric cancer had disseminated peritoneally. Chemotherapy was selected as treatment for recurrent gastric cancer...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133252/-a-case-of-locally-far-advanced-colon-cancer-resected-by-laparoscopic-surgery-after-colonic-stent-insertion-and-neoadjuvant-chemotherapy
#17
Yasushi Ishii, Yosuke Hirano, Taro Munechika, Keita Tanaka, Yoshihiro Yonemitsu, Masako Nomi, Ryosuke Shibata, Tatsuya Okamoto, Hiroshi Maeno, Jun Yanagisawa, Shunji Kawamoto, Tomoaki Noritomi
We report a case of locally far-advanced colon cancer resected by laparoscopic surgery after colonic stent insertion and neoadjuvant chemotherapy. A 71-year-old man with obstructive symptoms was admitted to our hospital in July 2015. CT revealed a sigmoid colon tumor infiltrating the retroperitoneum and small intestine. Lower gastrointestinal endoscopy showed a sigmoid colon cancer. Self-expandable metallic stent insertion for obstructive colon cancer alleviated the patient's symptoms quickly. Four courses of neoadjuvant chemotherapy(XELOX)reduced the primary tumor in size, allowing for laparoscopic surgical resection...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133081/-three-cases-of-unresectable-advanced-and-recurrent-colorectal-cancer-associated-with-gastrointestinal-obstruction-that-were-treated-with-small-intestine-transverse-colon-bypass-surgery
#18
Arika Ida, Akira Miyaki, Tatsuomi Miyauchi, Kentaro Yamaguchi, Yoshihiko Naritaka
Herein, we report 3cases of unresectable, advanced, and recurrent colorectal cancer associated with gastrointestinal obstruction. The patients were treated with small intestine-transverse colon bypass surgery, which improved the quality of life (QOL)in all cases. Case 1 was an 80-year-old woman who presented with subileus due to ascending colon cancer. After surgery, her oral intake was reestablished, and she was discharged home. Case 2 was an 89-year-old woman whose ileus was caused by cecal cancer with multiple hepatic metastases...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133075/-two-cases-of-obstructive-colorectal-cancer-effectively-treated-with-colonic-stent-placement
#19
Taiki Masuda, Kenta Kobayashi, Masaki Kakimoto, Haruya Koshiishi, Tetsunori Yoshimura
We report 2 cases of obstructive colorectal cancer that were successfully treated with a self-expanding metallic stent (SEMS). They were both diagnosed with obstructive colorectal cancer. Colonoscopy was performed to make a definitive and qualitative diagnosis and to relieve the stenosis using a SEMS. The SEMSs were inserted without complications. A few days later, the patients underwent laparoscope-assisted sigmoidectomy with lymph node resection. Despite the colon obstruction, a primary anastomosis was performed...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28119864/obstructive-left-colon-cancer-should-be-managed-by-using-a-subtotal-colectomy-instead-of-colonic-stenting
#20
Chung Ki Min, Hyung Ook Kim, Donghyoun Lee, Kyung Uk Jung, Sung Ryol Lee, Hungdai Kim, Ho-Kyung Chun
PURPOSE: This study compared a subtotal colectomy to self-expandable metallic stent (SEMS) insertion as a bridge to surgery for patients with left colon-cancer obstruction. METHODS: Ninety-four consecutive patients with left colon-cancer obstruction underwent an emergency subtotal colectomy or elective SEMS insertion between January 2007 and August 2014. Using prospectively collected data, we performed a retrospective comparative analysis on an intention-to-treat basis...
December 2016: Annals of Coloproctology
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