WallFlex colonic stent placement for management of malignant colonic obstruction: a prospective study at two centers - 23/08/11
Reprint requests: Alessandro Repici, MD, Digestive Endoscopy Unit, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (MI), 20089 Italy.Milano, Bologna, Italy
Abstract |
Background |
Self-expanding metal stents (SEMSs) can alleviate malignant colonic obstruction and avoid emergency decompressive surgery. The use of colonic larger-diameter SEMSs may improve bowel function and reduce migration risk.
Objective |
To evaluate the effectiveness and safety of a novel large-diameter SEMS (WallFlex) designed for delivery through the endoscope in treating malignant colonic obstruction.
Design |
Prospective clinical cohort study.
Setting |
Two Italian study centers.
Patients |
Forty-two consecutive patients with malignant colonic obstruction: 23 requiring palliation and 19 bridging to surgery.
Interventions |
Colorectal SEMS placement.
Main Outcome Measurements |
Technical success, defined as accurate SEMS deployment across the stricture on the first attempt; clinical success, ie, complete relief of bowel obstruction without complications; and bridging to surgery, denoting the performance of elective one-stage surgery.
Results |
The rate of technical success was 93% (95% CI, 81%-99%) and of initial clinical success was 95% (95% CI, 84%-99%). In 58% (95% CI, 40%-84%) of the palliation group, clinical success was maintained after 6 months. All 19 patients with operable tumors were successfully bridged to one-stage elective surgery within a median of 5 days. One perforation and one stent migration occurred. All complications could be resolved nonsurgically.
Limitations |
No control group was included.
Conclusions |
In a prospective study of through-the-scope WallFlex stent placement for malignant colonic obstruction, high rates of technical and initial clinical success, and bridging to surgery were achieved. Complications could be readily managed.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : SEMS, TTS
Mappa
| Presented at the Digestive Disease Week, May 20-23, 2007, Washington, DC (Gastrointest Endosc 2007;65:AB283). |
Vol 67 - N° 1
P. 77-84 - gennaio 2008 Ritorno al numero
Articolo precedente
- Self-expandable metal stents in acute malignant colonic obstruction: shall you cross this bridge?
- Eduardo da Silveira, Alan N. Barkun
- Making sense out of colonic stents
- Richard Kozarek
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