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Title: Colorectal Stenting: An Effective Therapy for Preoperative and Palliative Treatment

Abstract

Purpose. To demonstrate the effectiveness of preoperative and palliative colorectal stent placement in acute colonic obstruction. Methods. Sixty-seven consecutive patients (mean age 67.3 years, range 25-93 years) with clinical and radiological signs of colonic obstruction were treated: 45 (67%) preoperatively and 22 (33%) with a palliative intent. In 59 patients (88%) the obstruction was malignant, while in 8 (12%) it was benign. A total of 73 enteric Wallstents were implanted under combined fluoroscopic/endoscopic guidance. Results. Forty-five patients were treated preoperatively with a technical success rate of 84%, a clinical success rate of 83%, and a complication rate of 16%. Of the 38 patients who were successfully stented preoperatively, 36 (95%) underwent surgery 2-22 days (mean 7.2 days) after stent insertion. The improved general condition and adequate bowel cleansing allowed single-stage tumor resection and primary end-to-end anastomosis without complications in 31 cases (86% of all operations), while only 5 patients had colostomies. Stent placement was used as the final palliative treatment in 22 patients. The technical success rate was 95%, the clinical success rate 72%, and the complication rate relatively high at 67%, caused by reocclusion in most cases. After noninvasive secondary interventions (e.g., tube placement, second stenting, balloon dilatation) themore » secondary patency of stents was 71% and mean reported survival time after stent insertion was 92 days (range 10-285 days). Conclusion. Preoperative stent placement in acute colonic obstruction is minimally invasive and allows an elective one-stage surgery in most cases. Stent placement also proved a valuable alternative to avoid colostomy in palliation.« less

Authors:
 [1];  [2];  [1];  [3];  [2]
  1. Kantonsspital Winterthur, Department of Internal Medicine, Section of Gastroenterology (Switzerland)
  2. Kantonsspital Winterthur, Department of Radiology (Switzerland)
  3. Kantonsspital Winterthur, Department of Surgery (Switzerland)
Publication Date:
OSTI Identifier:
21090989
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 30; Journal Issue: 3; Other Information: DOI: 10.1007/s00270-006-0012-0; Copyright (c) 2007 Springer Science+Business Media, Inc.; www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; NEOPLASMS; PATIENTS; SURGERY; SURVIVAL TIME; THERAPY

Citation Formats

Jost, Rahel S., Jost, Res, Schoch, Erich, Brunner, Brigit, Decurtins, Marco, and Zollikofer, Christoph L. Colorectal Stenting: An Effective Therapy for Preoperative and Palliative Treatment. United States: N. p., 2007. Web. doi:10.1007/S00270-006-0012-0.
Jost, Rahel S., Jost, Res, Schoch, Erich, Brunner, Brigit, Decurtins, Marco, & Zollikofer, Christoph L. Colorectal Stenting: An Effective Therapy for Preoperative and Palliative Treatment. United States. https://doi.org/10.1007/S00270-006-0012-0
Jost, Rahel S., Jost, Res, Schoch, Erich, Brunner, Brigit, Decurtins, Marco, and Zollikofer, Christoph L. 2007. "Colorectal Stenting: An Effective Therapy for Preoperative and Palliative Treatment". United States. https://doi.org/10.1007/S00270-006-0012-0.
@article{osti_21090989,
title = {Colorectal Stenting: An Effective Therapy for Preoperative and Palliative Treatment},
author = {Jost, Rahel S. and Jost, Res and Schoch, Erich and Brunner, Brigit and Decurtins, Marco and Zollikofer, Christoph L},
abstractNote = {Purpose. To demonstrate the effectiveness of preoperative and palliative colorectal stent placement in acute colonic obstruction. Methods. Sixty-seven consecutive patients (mean age 67.3 years, range 25-93 years) with clinical and radiological signs of colonic obstruction were treated: 45 (67%) preoperatively and 22 (33%) with a palliative intent. In 59 patients (88%) the obstruction was malignant, while in 8 (12%) it was benign. A total of 73 enteric Wallstents were implanted under combined fluoroscopic/endoscopic guidance. Results. Forty-five patients were treated preoperatively with a technical success rate of 84%, a clinical success rate of 83%, and a complication rate of 16%. Of the 38 patients who were successfully stented preoperatively, 36 (95%) underwent surgery 2-22 days (mean 7.2 days) after stent insertion. The improved general condition and adequate bowel cleansing allowed single-stage tumor resection and primary end-to-end anastomosis without complications in 31 cases (86% of all operations), while only 5 patients had colostomies. Stent placement was used as the final palliative treatment in 22 patients. The technical success rate was 95%, the clinical success rate 72%, and the complication rate relatively high at 67%, caused by reocclusion in most cases. After noninvasive secondary interventions (e.g., tube placement, second stenting, balloon dilatation) the secondary patency of stents was 71% and mean reported survival time after stent insertion was 92 days (range 10-285 days). Conclusion. Preoperative stent placement in acute colonic obstruction is minimally invasive and allows an elective one-stage surgery in most cases. Stent placement also proved a valuable alternative to avoid colostomy in palliation.},
doi = {10.1007/S00270-006-0012-0},
url = {https://www.osti.gov/biblio/21090989}, journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 3,
volume = 30,
place = {United States},
year = {Fri Jun 15 00:00:00 EDT 2007},
month = {Fri Jun 15 00:00:00 EDT 2007}
}