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Self-expanding metal stents in malignant colonic obstruction: experiences from Sweden.

Lepsenyi, Mattias LU ; Santén, Stefan LU ; Syk, Ingvar LU ; Nielsen, Jörgen; Nemeth, Artur LU ; Toth, Ervin LU and Thorlacius, Henrik LU (2011) In BMC Research Notes 4.
Abstract
BACKGROUND:

Acute surgery in the management of malignant colonic obstruction is associated with high morbidity and mortality. The use of self-expanding metal stents (SEMS) is an alternative method of decompressing colonic obstruction. SEMS may allow time to optimize the patient and to perform preoperative staging, converting acute surgery into elective. SEMS is also proposed as palliative treatment in patients with contraindications to open surgery. Aim: To review our experience of SEMS focusing on clinical outcome and complications. The method used was a review of 75 consecutive trials at SEMS on 71 patients based on stent-protocols and patient charts.



FINDINGS:

SEMS was used for palliation in 64 (85%)... (More)
BACKGROUND:

Acute surgery in the management of malignant colonic obstruction is associated with high morbidity and mortality. The use of self-expanding metal stents (SEMS) is an alternative method of decompressing colonic obstruction. SEMS may allow time to optimize the patient and to perform preoperative staging, converting acute surgery into elective. SEMS is also proposed as palliative treatment in patients with contraindications to open surgery. Aim: To review our experience of SEMS focusing on clinical outcome and complications. The method used was a review of 75 consecutive trials at SEMS on 71 patients based on stent-protocols and patient charts.



FINDINGS:

SEMS was used for palliation in 64 (85%) cases and as a bridge to surgery in 11 (15%) cases. The majority of obstructions, 53 (71%) cases, were located in the recto-sigmoid. Technical success was achieved in 65 (87%) cases and clinical decompression was achieved in 60 (80%) cases. Reasons for technical failure were inability to cannulate the stricture in 5 (7%) cases and suboptimal SEMS placement in 3 (4%) cases. Complications included 4 (5%) procedure-related bowel perforations of which 2 (3%) patients died in junction to post operative complications. Three cases of bleeding after SEMS occurred, none of which needed invasive treatment. Five of the SEMS occluded. Two cases of stent erosion were diagnosed at the time of surgery. Average survival after palliative SEMS treatment was 6 months.



CONCLUSION:

Our results correspond well to previously published data and we conclude that SEMS is a relatively safe and effective method of treating malignant colonic obstruction although the risk of SEMS-related perforations has to be taken into account. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Research Notes
volume
4
publisher
BioMed Central
external identifiers
  • PMID:21801447
  • Scopus:79960883272
ISSN
1756-0500
DOI
10.1186/1756-0500-4-274
language
English
LU publication?
yes
id
8cdd0756-1861-4f0d-8ebd-be08d559ad74 (old id 2151664)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21801447?dopt=Abstract
date added to LUP
2011-09-04 17:04:42
date last changed
2016-10-13 04:23:37
@misc{8cdd0756-1861-4f0d-8ebd-be08d559ad74,
  abstract     = {BACKGROUND:<br/><br>
Acute surgery in the management of malignant colonic obstruction is associated with high morbidity and mortality. The use of self-expanding metal stents (SEMS) is an alternative method of decompressing colonic obstruction. SEMS may allow time to optimize the patient and to perform preoperative staging, converting acute surgery into elective. SEMS is also proposed as palliative treatment in patients with contraindications to open surgery. Aim: To review our experience of SEMS focusing on clinical outcome and complications. The method used was a review of 75 consecutive trials at SEMS on 71 patients based on stent-protocols and patient charts.<br/><br>
<br/><br>
FINDINGS:<br/><br>
SEMS was used for palliation in 64 (85%) cases and as a bridge to surgery in 11 (15%) cases. The majority of obstructions, 53 (71%) cases, were located in the recto-sigmoid. Technical success was achieved in 65 (87%) cases and clinical decompression was achieved in 60 (80%) cases. Reasons for technical failure were inability to cannulate the stricture in 5 (7%) cases and suboptimal SEMS placement in 3 (4%) cases. Complications included 4 (5%) procedure-related bowel perforations of which 2 (3%) patients died in junction to post operative complications. Three cases of bleeding after SEMS occurred, none of which needed invasive treatment. Five of the SEMS occluded. Two cases of stent erosion were diagnosed at the time of surgery. Average survival after palliative SEMS treatment was 6 months.<br/><br>
<br/><br>
CONCLUSION:<br/><br>
Our results correspond well to previously published data and we conclude that SEMS is a relatively safe and effective method of treating malignant colonic obstruction although the risk of SEMS-related perforations has to be taken into account.},
  author       = {Lepsenyi, Mattias and Santén, Stefan and Syk, Ingvar and Nielsen, Jörgen and Nemeth, Artur and Toth, Ervin and Thorlacius, Henrik},
  issn         = {1756-0500},
  language     = {eng},
  publisher    = {ARRAY(0x8267fd0)},
  series       = {BMC Research Notes},
  title        = {Self-expanding metal stents in malignant colonic obstruction: experiences from Sweden.},
  url          = {http://dx.doi.org/10.1186/1756-0500-4-274},
  volume       = {4},
  year         = {2011},
}