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Endoluminal Stent Colon

C E Munro, Gfw Stamp, A W Phillips, S M Griffin
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...
April 2018: Annals of the Royal College of Surgeons of England
Canaan Baer, Raman Menon, Sarah Bastawrous, Amir Bastawrous
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...
June 2017: Surgical Clinics of North America
Heng Boon Yim
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...
April 2014: Annals of Palliative Medicine
Takuma Arai, Masahiro Sakon, Taishi Fujii, Shinji Sawano, Satoshi Nagano, Mitsuyo Umegaki, Akira Kawashima, Shiro Miwa
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...
December 2014: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Ricardo Frago, Elena Ramirez, Monica Millan, Esther Kreisler, Emilio del Valle, Sebastiano Biondo
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...
January 2014: American Journal of Surgery
Cole, Boorman, Osman, Sathananthan, Parker
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...
September 2000: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Roberto Cirocchi, Eriberto Farinella, Stefano Trastulli, Jacopo Desiderio, Chiara Listorti, Carlo Boselli, Amilcare Parisi, Giuseppe Noya, Jayesh Sagar
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...
March 2013: Surgical Oncology
Kwang An Kwon, Il Ju Choi, Eun Young Kim, Seok Ho Dong, Ki Baik Hahm
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...
September 2012: Clinical Endoscopy
Ricardo Frago, Esther Kreisler, Sebastiano Biondo, Esther Alba, Juan Domínguez, Thomas Golda, Domenico Fraccalvieri, Mónica Millán, Loris Trenti
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...
August 2011: Cirugía Española
Silvana Perretta, James K Wall, Bernard Dallemagne, Michael Harrison, François Becmeur, Jacques Marescaux
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...
October 2011: Surgical Endoscopy
Rebecca A Levine, Harry Wasvary, Omar Kadro
BACKGROUND: The role of endoluminal stenting in benign obstruction, especially for Crohn's disease (CD), is controversial, with limited data and widely disparate outcomes. The purpose of this study was to determine the long-term efficacy and safety of this technology in the treatment of fibrostenotic CD and to review the existing literature on this topic. METHODS: We undertook a retrospective review of all patients undergoing endoluminal stenting for CD strictures at our institution from 2001 to 2010...
March 2012: Inflammatory Bowel Diseases
Yik Hong Ho, Mohamed Ahmed Tawfik Ashour
Colorectal anastomotic leak remains one of the most feared post-operative complications, particularly after anterior resection of the rectum with, the shift from abdomino-peritoneal resections to total mesorectal excision and primary anastomosis. The literature fails to demonstrate superiority of stapled over hand-sewn techniques in colorectal anastomosis, regardless of the level of anastomosis, although a high stricture rate was noted in the former technique. Thus, improvements in safety aspects of anastomosis and alternatives to hand-sewn and stapled techniques are being sought...
April 7, 2010: World Journal of Gastroenterology: WJG
Ilona Keränen, Anna Lepistö, Marianne Udd, Jorma Halttunen, Leena Kylänpää
OBJECTIVE: Self-expanding metal stents (SEMS) have been successfully used as a "bridge to surgery" or as palliation for acute malignant colorectal obstruction. Little data on the use of stents for benign obstruction exists and the results vary. The purpose of this study was to evaluate the efficacy and safety of SEMS in benign colorectal obstruction. MATERIAL AND METHODS: A total of 21 patients with 23 SEMS procedures between the years 1998 and 2008 were retrospectively studied...
June 2010: Scandinavian Journal of Gastroenterology
Hester Yui Shan Cheung, Chi Chiu Chung, Wilson Wen Chieng Tsang, James Cheuk Hoo Wong, Kevin Kwok Kay Yau, Michael Ka Wah Li
OBJECTIVE: To compare self-expanding metal stents with emergency open surgery in the treatment of obstructing left-sided colon cancer. DESIGN: A randomized controlled trial. SETTING: An acute care hospital. PATIENTS: Adult patients with an obstructing tumor between the splenic flexure and rectosigmoid junction. MAIN OUTCOME MEASURES: Successful 1-stage operation, cumulative operative time, blood loss, hospital stay, pain score, and postoperative complications...
December 2009: Archives of Surgery
Maher A Abbas
Acute postoperative anastomotic complications following colorectal resection include leak and obstruction. Often an operation is necessary to treat these complications. The role of endoluminal procedures to treat these complications has been limited. This article illustrates that such an approach is technically feasible and can be used to treat some colorectal anastomotic complications.
July 2009: JSLS: Journal of the Society of Laparoendoscopic Surgeons
George A Poultsides, Elliot L Servais, Leonard B Saltz, Sujata Patil, Nancy E Kemeny, Jose G Guillem, Martin Weiser, Larissa K F Temple, W Douglas Wong, Phillip B Paty
PURPOSE: The purpose of this study was to describe the frequency of interventions necessary to palliate the intact primary tumor in patients who present with synchronous, stage IV colorectal cancer (CRC) and who receive up-front modern combination chemotherapy without prophylactic surgery. PATIENTS AND METHODS: By using a prospective institutional database, we identified 233 consecutive patients from 2000 through 2006 with synchronous metastatic CRC and an unresected primary tumor who received oxaliplatin- or irinotecan-based, triple-drug chemotherapy (infusional fluorouracil, leucovorin, and oxaliplatin; bolus fluorouracil, leucovorin, and irinotecan; or fluorouracil, leucovorin, and irinotecan) with or without bevacizumab as their initial treatment...
July 10, 2009: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Zurab Tsereteli, Emanuel Sporn, Timothy M Geiger, Dava Cleveland, Shellaine Frazier, Arthur Rawlings, Sharon L Bachman, Brent W Miedema, Klaus Thaler
BACKGROUND: Anastomotic leaks after colorectal operation continue to be a significant cause of morbidity. A covered endoluminal stent could seal a leak and eliminate the need for diversion. The aim of this study was to test the efficacy of a temporary covered stent to prevent leak related complications. METHODS: Sixteen adult pigs (80-120 lbs) underwent open transection of the rectosigmoid followed by anastomosis with a circular stapler. Eight animals (study group) underwent endoscopic placement of a 21-mm covered polyester stent...
November 2008: Surgery
J E van Hooft, P Fockens, A W Marinelli, R Timmer, A M van Berkel, P M Bossuyt, W A Bemelman
BACKGROUND AND STUDY AIMS: The introduction of self-expandable metal stents has offered a promising alternative for palliation of malignant left-sided colonic obstruction. This randomized clinical trial aimed to assess whether a nonsurgical policy, with endoluminal stenting, is superior to surgical treatment in patients with stage IV left-sided colorectal cancer and imminent obstruction. PATIENTS AND METHODS: Patients with incurable left-sided colorectal cancer who fulfilled the study criteria were randomly assigned to nonsurgical or surgical treatment...
March 2008: Endoscopy
F Stipa, A Pigazzi, B Bascone, A Cimitan, G Villotti, A Burza, A Vitale
BACKGROUND: About one-third of patients with colorectal carcinoma present with acute colonic obstruction requiring emergency surgery. Current surgical options are intraoperative lavage and resection of the colonic segment involved with primary anastomosis, subtotal colectomy with primary anastomosis, colostomy followed by resection, and resection of the colonic segment involved with end colostomy (Hartmann's procedure) requiring a second operation to reconstruct the colon. These procedures present risks and a poor quality of life...
June 2008: Surgical Endoscopy
Arild Nesbakken, Maria Gaard
BACKGROUND: The incidence of colon cancer is increasing in Norway and about 2200 new cases are now diagnosed each year. This paper presents accepted principles of the surgical treatment of the disease. MATERIAL AND METHODS: The article is based on literature retrieved from the PubMed and Cochrane databases, guidelines from other European countries and USA, and the authors' clinical experience. RESULTS AND INTERPRETATION: Some 2 / 3 of the patients have no distant metastases and a resectable primary tumour, and the intention of treatment is curative...
November 15, 2007: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
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