Preoperative colonoscopy after self-expandable metallic stent placement in patients with acute neoplastic colon obstruction - 19/08/11
Reprint requests: Mario Alessandro Vitale, MD, Gastroenterology and Endoscopy Unit, San-Giovanni Addolorata-Calvary Hospital, Largo dell’Artide 19, 00144, Rome, Italy.Rome, Italy
Abstract |
Background |
In patients with colorectal cancer, a preoperative colonoscopy is recommended to exclude synchronous lesions. Unfortunately, between 7% and 29% of patients with colorectal cancer present with acute colonic obstruction, making complete colonoscopy impossible.
Objective |
The aim of our study was to evaluate the feasibility of a preoperative colonoscopy after effective stent placement in patients with acute neoplastic obstruction.
Design |
Single-center prospective study.
Setting |
All examinations were carried out at a tertiary referral center with 24-hour emergency endoscopy service.
Patients |
Fifty-seven patients with acute neoplastic colon obstruction.
Interventions |
Patients who recovered from an acute colon obstruction by an effective stent placement and who had a resectable cancer underwent a preoperative colonoscopy.
Main Outcome Measurements |
Patients with a resectable cancer, complete preoperative colonoscopies, and synchronous lesions rates.
Results |
Self-expandable metallic stents (SEMS) were placed in 50 of 57 patients (87.8%). Thirty-one of 50 patients had a resectable cancer (62%), and a complete preoperative colonoscopy was possible in 29 of 31 patients (93.4%). A synchronous cancer was detected in 3 patients (9.6%), changing the surgical plan.
Limitations |
Seven patients in whom the SEMS placement (12.2%) was unsuccessful underwent an urgent surgical intervention. Nineteen of 50 patients who had stent placement were not eligible for our study because of unresectable cancer.
Conclusions |
Our study indicates that it is feasible in a majority of patients to perform full preoperative colonoscopy after relief of acute colonic obstruction with SEMS before surgical resection.
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Vol 63 - N° 6
P. 814-819 - mai 2006 Retour au numéro
Article précédent
- A prospective control study of the safety and cellular yield of EUS-guided FNA or Trucut biopsy in patients taking aspirin, nonsteroidal anti-inflammatory drugs, or prophylactic low molecular weight heparin
- Charles Kien-Fong Vu, Fuju Chang, Laura Doig, John Meenan
- Malignant colorectal obstruction: looking for synchronous lesions with the scope through a metal stent…!
- Deepak Kumar Bhasin, Surinder Singh Rana
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