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Management of acute malignant large-bowel obstruction with self-expanding metal stent

Abstract :

PURPOSE: Colorectal stents are being used for palliation and as a "bridge to surgery" in obstructing colorectal carcinoma. The purpose of this study was to review our experience with self-expanding metal stents (SEMS) as the initial interventional approach in the management of acute malignant large-bowel obstruction.

METHODS: Between February 2002 and August 2009, 93 patients underwent the insertion of a SEMS for an obstructing malignant lesion of the left-sided colon or rectum.

RESULTS: In 66 patients, the stents were placed for palliation; whereas, in 27 patients they were placed as a bridge to surgery. Stent placement was technically successful in 92.5% (n = 86) of the patients, with a clinical success rate of 86% (n = 80). Three perforations occurred during stent placement, two were treated by an emergency Hartmann operation, and one by a colostomy. In the intention to treat by stent, the peri-interventional mortality was 6.5% (6/93). Stent migration was reported in three cases (3%), and stent obstruction occurred in 11 cases (12%). Of the 24 patients with stents successfully placed as a bridge to surgery, 22 underwent elective single-stage operations with no death or anastomotic complication.

CONCLUSION: Stent insertion provided an effective outcome in patients with malignant colonic obstruction as a palliative and preoperative therapy.

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https://hal.univ-angers.fr/hal-03269729
Contributeur : Okina Université d'Angers <>
Soumis le : jeudi 24 juin 2021 - 11:34:45
Dernière modification le : mardi 13 juillet 2021 - 03:18:53

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Frédéric Branger, Emilie Thibaudeau, Stéphanie Mucci-Hennekinne, Elodie Cesbron-Métivier, Karina Vychnevskaia, et al.. Management of acute malignant large-bowel obstruction with self-expanding metal stent. International journal of colorectal disease, 2010, 25 (12), pp.1481-1485. ⟨10.1007/s00384-010-1003-9⟩. ⟨hal-03269729⟩

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