Endoluminal Stent Colon

Background  Currently, the methods for drainage of pelvic abscess primarily use computed tomography- or ultrasound-guided percutaneous drainage or surgical drainage. Endoscopic ultrasound-guided pelvic abscess drainage (EUS-PAD) is an alternative, minimally invasive tool to drain an abscess, localized close to the rectum or left colon, and therefore not accessible by other means. Methods  We report on the success of endoscopic ultrasound-guided drainage of peridiverticulitic abscess based on the two cases presented here...

BACKGROUND AND AIMS: The relative utility of self-expanding metal stent (SEMS) insertion for malignant colon obstruction (MCO) due to extra-colonic malignancy (ECM) versus intra-colonic malignancy (ICM) is understudied. METHODS: A systematic search was done from inception-April 2021 to identify reports of safety and efficacy of SEMS insertion for the treatment of MCO-ECM versus MCO-ICM. A meta-analysis of proportions, comparative meta-analysis to compute relative risks (RR), and mean differences (MD) was performed...

BACKGROUND: Colorectal cancer often presents with obstruction needing urgent, potentially life-saving decompression. The comparative efficacy and safety of endoluminal stenting versus emergency surgery as initial treatment for such patients is uncertain. METHODS: Patients with left-sided colonic obstruction and radiological features of carcinoma were randomized to endoluminal stenting using a combined endoscopic/fluoroscopic technique followed by elective surgery 1-4 weeks later, or surgical decompression with or without tumour resection...

Despite an increase in screening colonoscopy, with the objective to decrease the incidence of colorectal cancer, a third of patients will present with an obstructing cancer. Malignant large bowel obstructions (MLBO) pose a challenging workup and treatment paradigm where an oncologic primary tumor resection must be balanced with relieving the obstruction, functional outcomes, palliation, and consideration for adjuvant therapy. A thorough work up with cross-sectional imaging and medical optimization should be attempted; however, patients may present in extremis and require emergent intervention...

Endoscopic stenting is a well-established option for the treatment of malignant obstruction, temporary management of benign strictures, and sealing transmural defects, as well as drainage of pancreatic fluid collections and biliary obstruction. In recent years, in addition to expansion in indications for endoscopic stenting, considerable strides have been made in stent technology, and several types of devices with advanced designs and materials are continuously being developed. In this review, we discuss the important developments in stent designs and novel indications for endoluminal and transluminal stenting...

Purpose: The emergency intervention for acute malignant left-sided colonic obstruction remains controversial. Conflicting reports exist regarding the efficacy and safety of endoscopic placement of self-expandable metallic stents (SEMS) vs. primary surgery. Most reports focus on SEMS insertion as a bridge to surgery. Methods: An observational nonrandomized study at a single center in Cairo, Egypt included 65 high-risk patients (American Society of Anesthesiologists physical status classification ≥ III, age > 60 years) with acute malignant metastatic (stage IV) colonic obstruction...

Background: The emergency intervention for acute malignant left-sided colonic obstruction remains controversial. Conflicting reports exist regarding the efficacy and safety of endoscopic placement of self-expandable metallic stents (SEMS) versus primary surgery. Most reports focus on SEMS insertion as a bridge to surgery. Methods: An observational non-randomized study at a single center in Cairo, Egypt included 65 high-risk patients (American Society of Anesthesiologists Preoperative Score: III or more, and age over 60 years) with acute malignant (Stage IV) colonic obstruction...

BACKGROUND/AIM: Endoluminal self-expanding metallic stents (SEMS) may overcome the risk of mortality and morbidity of acute intestinal obstruction because of stage IV colon (CC) or rectal (RC) cancer. We evaluated the QoL in these groups of patients. PATIENTS AND METHODS: Forty-eight patients were enrolled in a prospective longitudinal cohort single-center trial to undergo SEMS positioning. Twenty-five patients had a CC and 23 RC. Karnofsky performance scale, Visual Analogue Scale and the EQ-5D- 5L™ questionnaire were administered before treatment and at 1, 3 and 6 months...

INTRODUCTION: The debate on the best surgical management strategy for acute malignant left-sided colonic obstruction is ongoing. Decompressing colostomy (DC) and stenting as a bridge to surgery (SBTS) are the currently proposed alternative approaches to emergency colectomy (EC). However, the results of a traditional meta-analysis were inconclusive. Therefore, a network meta-analysis (NMA) was conducted to compare the three approaches for acute left-sided colonic obstruction. METHODS: A systematic literature search of Embase, PubMed, Google Scholar and the Cochrane library was performed...

BACKGROUND: Placement of self-expanding metal stents has been increasingly adopted as a bridge to surgery in patients presenting with obstructed left-sided colorectal cancers. The optimal bridging time has yet to be widely established, hence this retrospective study aims to determine the optimal bridging time to elective surgery post endoluminal stenting. PATIENTS AND METHODS: All patients who underwent colorectal stenting for large bowel obstruction in a single, tertiary hospital in Singapore between January 2003 and December 2017 were retrospectively identified...

The use of endoluminal stents to treat anastomotic leaks post oesophagogastric resection remains controversial. While some advocate stents to expedite recovery, others advise caution due to the risk of major morbidity and mortality. We describe a case of anastomotic leak following total gastrectomy for adenocarcinoma treated with a self-expanding metallic stent. Complications with the initial stent were treated with a further stent, which compromised the function of the oesophagus and eroded into the aorta, necessitating a colonic reconstruction and endovascular aortic stenting...

Many colorectal carcinomas will present emergently with issues such as obstruction, perforation, and bleeding. Emergency surgery is associated with poor short- and long-term outcomes. For abnormality localizing to the colon proximal to the splenic flexure, surgical management with hemicolectomy is often a safe and appropriate approach. Obstructions are more common in the distal colon, however, where there is an evolving spectrum of surgical and nonsurgical options, most notably by the development of endoluminal stents...

Endoluminal stenting has revolutionised the practice of gastrointestinal endoscopy for many years. What started as rigid, inflexible, plastic stents have now evolved into flexible, easy-to-deploy self-expanding stents with a myriad of choices, including covered, partially covered and uncovered types. Many of these also come along with special features including anti-reflux, anti-migration and lasso for stent adjustment and retrieval. Numerous papers with meta-analyses and systemic reviews have without doubt confirmed the efficacy, safety and cost effectiveness of endoluminal stenting in the palliation of malignant obstruction of the oesophagus, stomach, duodenum, colon and the biliary tree...

PURPOSE: The aim of this small study was to assess the clinical outcomes of self-expanding metallic stent (SEMS) placement followed by 1-stage laparoscopic resection for treatment of acute right-sided colonic obstruction due to carcinoma. METHOD: From January 2012 to December 2012, we performed 1-stage laparoscopic colectomy after placement of SEMS for right-sided obstructive colon carcinoma in 4 patients. RESULTS: SEMS placement was technically successful in all cases and symptoms were immediately relieved...

BACKGROUND: The management of colonic obstruction has changed in recent years. In distal obstruction, optimal treatment remains controversial, particularly after the appearance and use of colonic endoluminal stents. The purpose of this study was to review the current treatment of acute malignant large bowel obstruction according to the level of evidence of the available literature. METHODS: A systematic search was conducted in PubMed, MEDLINE, Embase, and Google Scholar for articles published through January 2013 to identify studies of large bowel obstruction and colorectal cancer...

OBJECTIVE: The aim of this study was to investigate the outcome of endoluminal stenting in the management of patients presenting with acute large bowel obstruction. PATIENTS AND METHODS: Twenty-eight consecutive patients presenting to one consultant surgeon with large bowel obstruction were considered for the procedure. RESULTS: Twenty-four patients were successfully treated using this modality, which is to date the largest series in the UK...

INTRODUCTION: Colorectal carcinoma can present with acute intestinal obstruction in 7%-30% of cases, especially if tumor is located at or distal to the splenic flexure. In these cases, emergency surgical decompression becomes mandatory as the traditional treatment option. It involves defunctioning stoma with or without primary resection of obstructing tumor. An alternative to surgery is endoluminal decompression. The aim of this review is to assess the effectiveness of colonic stents, used as a bridge to surgery, in the management of malignant left colonic and rectal obstruction...

This special September issue of Clinical Endoscopy will discuss various aspects of diagnostic and therapeutic advancement of gastrointestinal (GI) endoscopy, explaining what is new in digestive endoscopy and why international network should be organized. We proposed an integrated model of international conference based on the putative occurrence of Digestive Endoscopy Networks. In International Digestive Endoscopy Network (IDEN) 2012, role of endoscopy in gastroesophageal reflux disease and Barrett's esophagus, endoscopy beyond submucosa, endoscopic treatment for stricture and leakage in upper GI, how to estimate the invasion depth of early GI cancers, colonoscopy in inflammatory bowel disease (IBD), a look into the bowel beyond colon in IBD, management of complications in therapeutic colonoscopy, revival of endoscopic papllirary balloon dilation, evaluation and tissue acquisition for indeterminate biliopancreatic stricture, updates in the evaluation of pancreatic cystic lesions, issues for tailored endoscopic submucosal dissection (ESD), endoluminal stents, management of upper GI bleeding, endoscopic management of frustrating situations, small bowel exploration, colorectal ESD, valuable tips for frustrating situations in colonoscopy, choosing the right stents for endoscopic stenting of biliary strictures, advanced techniques for pancreaticobiliary visualization, endoscopic ultrasound-guided biliopancreatic drainage, and how we can overcome the obstacles were deeply touched...

INTRODUCTION: The high morbidity and mortality of emergency surgery, has led to the use of endoluminal self-expanding metal implants (stents) in the management of intestinal occlusion. The purpose of this study was to review the results of the management of intestinal occlusion treatment in a Colorectal Surgery Unit in those patients who had a stent implant, and the relationship between chemotherapy and complications. MATERIAL AND METHODS: A retrospective study was carried out on patients treated with a stent in a university hospital between 2004 and 2010...

BACKGROUND: Esophageal reconstruction presents a significant clinical challenge in patients ranging from neonates with long-gap esophageal atresia to adults after esophageal resection. Both gastric and colonic replacement conduits carry significant morbidity. As emerging organ-sparring techniques become established for early stage esophageal tumors, less morbid reconstruction techniques are warranted. We present two novel endoscopic approaches for esophageal lengthening and reconstruction in a porcine model...