Colonic stenting for malignant obstructions-A review of current indications and outcomes - 20/06/22
, Gabie Ong b , Peter Davis a , Jonathan Weyerbacher c , Jonathan Saxe a Abstract |
Background |
Colonic stenting has emerged as preferred palliative treatment for left sided malignant obstructions. It shortens hospital stays, decreases healthcare cost, reduces permanent stoma rates, and expedites the start of chemotherapy. The role of stenting as a bridge-to-surgery remains unsettled.
Data source |
For this paper the recommendations of the American and European society of gastroenterology and colorectal surgery were reviewed. We will discuss the benefits and risks of stenting in palliative setting and as bridge-to-surgery. Quality of life, hospital stay, and health care cost will also be considered.
Conclusion |
Non-traversable colon masses during endoscopy are considered a risk factor of development of intestinal obstruction but preventive stent placement in patients without obstructive symptoms is not recommended. The risk of technical or clinical failure is significant at 25%. If stent placement allows neoadjuvant chemotherapy, it may increase the rate of R0 resections. Perforations may raise local recurrence and mortality rates.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Self-expandable metal stents are well established in the palliative treatment of malignant left sided colonic obstruction. |
• | Stent-related perforation rate may be reduced with increasing provider experience and through-the-scope placement technique. |
• | Long term oncologic outcomes are equivalent in patients treated with stent placement. |
• | Colonic stenting shortens hospital stays and reduces overall healthcare cost. |
Mots-clés : BTS, CS, DC, ES, MCO, OTW, OS, QoL, RCT, SEMS, TDT, TTS
Keywords : Colon stent, SEMS, Malignant colonic obstruction, Colorectal cancer
Plan
Vol 224 - N° 1PA
P. 217-227 - juillet 2022 Retour au numéro
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