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Conference Paper: Self-expanding metallic stent in the treatment of colonic obstruction caused by advanced malignancies

TitleSelf-expanding metallic stent in the treatment of colonic obstruction caused by advanced malignancies
Authors
KeywordsColon and rectal obstruction
Metallic stents
Issue Date2000
PublisherSpringer New York LLC. The Journal's web site is located at http://www.springerlink.com/content/0012-3706/
Citation
The American Society of Colon and Rectal Surgeons' 100th Anniversary and Tripartite Meeting, Washington, D.C., USA, 1-6 May 1999. In Diseases Of The Colon And Rectum, 2000, v. 43 n. 11, p. 1522-1527 How to Cite?
AbstractINTRODUCTION: The treatment of malignant obstruction of the left colon or rectum usually requires emergency surgery on poor-risk patients, and the creation of a stoma is usually inevitable. With the use of self-expanding metallic stents, the prompt relief of large-bowel obstruction without surgery has become possible. This report describes our results in the use of self-expanding metallic stents in the treatment of left-sided colonic obstruction resulting from advanced malignancies. METHODS: From November 1997 to March 1999, insertion of self-expanding metallic stems was attempted in 24 patients with acute left-sided colonic obstruction caused by primary or recurrent malignancies. All the procedures were performed by colorectal surgeons. The guidewire was inserted through the channel of the endoscope, and its position was confirmed with fluoroscopy. Uncovered Wallstent® esophageal endoprostheses were used in all except the first case. The insertion and deployment of the stents were under both endoscopic and fluoroscopic guidance. RESULTS: There were 24 patients (15 males) with a mean age of 63.6 (range, 36-98) years. Thirteen patients had primary colorectal cancer and 11 had recurrent cancers (colorectal cancer, 5; gastric cancer, 5; other, 1). In the treatment of primary colorectal cancer, seven procedures were palliative, and no subsequent surgery was planned because of extensive liver metastasis or poor medical risk. The other six patients underwent elective resection after mechanical bowel preparation. There was no mortality related to the procedure. Stenting was successful in the relief of obstruction in 23 patients. Perforation of the colon occurred in one patient, and an emergency Hartmann's operation was performed. Migration of the stents occurred in three patients. Only 3 of the 18 patients in the palliation group required the subsequent creation of stomas. CONCLUSION: The use of the self-expanding metallic stents can achieve rapid and effective nonsurgical means to relieve left-sided colonic obstruction. It provides good palliation for unresectable advanced tumors that cause colonic obstruction. It may also have a role in the temporary relief of obstruction so that subsequent colonic resection can be performed under elective conditions.
Persistent Identifierhttp://hdl.handle.net/10722/83275
ISSN
2015 Impact Factor: 3.739
2015 SCImago Journal Rankings: 2.077
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWai Lun Lawen_HK
dc.contributor.authorKin Wah Chuen_HK
dc.contributor.authorHo, JWCen_HK
dc.contributor.authorHiu Ming Tungen_HK
dc.contributor.authorLaw, SYKen_HK
dc.contributor.authorChu, KMen_HK
dc.date.accessioned2010-09-06T08:39:05Z-
dc.date.available2010-09-06T08:39:05Z-
dc.date.issued2000en_HK
dc.identifier.citationThe American Society of Colon and Rectal Surgeons' 100th Anniversary and Tripartite Meeting, Washington, D.C., USA, 1-6 May 1999. In Diseases Of The Colon And Rectum, 2000, v. 43 n. 11, p. 1522-1527en_HK
dc.identifier.issn0012-3706en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83275-
dc.description.abstractINTRODUCTION: The treatment of malignant obstruction of the left colon or rectum usually requires emergency surgery on poor-risk patients, and the creation of a stoma is usually inevitable. With the use of self-expanding metallic stents, the prompt relief of large-bowel obstruction without surgery has become possible. This report describes our results in the use of self-expanding metallic stents in the treatment of left-sided colonic obstruction resulting from advanced malignancies. METHODS: From November 1997 to March 1999, insertion of self-expanding metallic stems was attempted in 24 patients with acute left-sided colonic obstruction caused by primary or recurrent malignancies. All the procedures were performed by colorectal surgeons. The guidewire was inserted through the channel of the endoscope, and its position was confirmed with fluoroscopy. Uncovered Wallstent® esophageal endoprostheses were used in all except the first case. The insertion and deployment of the stents were under both endoscopic and fluoroscopic guidance. RESULTS: There were 24 patients (15 males) with a mean age of 63.6 (range, 36-98) years. Thirteen patients had primary colorectal cancer and 11 had recurrent cancers (colorectal cancer, 5; gastric cancer, 5; other, 1). In the treatment of primary colorectal cancer, seven procedures were palliative, and no subsequent surgery was planned because of extensive liver metastasis or poor medical risk. The other six patients underwent elective resection after mechanical bowel preparation. There was no mortality related to the procedure. Stenting was successful in the relief of obstruction in 23 patients. Perforation of the colon occurred in one patient, and an emergency Hartmann's operation was performed. Migration of the stents occurred in three patients. Only 3 of the 18 patients in the palliation group required the subsequent creation of stomas. CONCLUSION: The use of the self-expanding metallic stents can achieve rapid and effective nonsurgical means to relieve left-sided colonic obstruction. It provides good palliation for unresectable advanced tumors that cause colonic obstruction. It may also have a role in the temporary relief of obstruction so that subsequent colonic resection can be performed under elective conditions.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.springerlink.com/content/0012-3706/en_HK
dc.relation.ispartofDiseases of the Colon and Rectumen_HK
dc.rightsThe original publication is available at www.springerlink.com-
dc.subjectColon and rectal obstructionen_HK
dc.subjectMetallic stentsen_HK
dc.subject.meshBiocompatible Materials-
dc.subject.meshColorectal Neoplasms - complications - mortality - radiography - surgery-
dc.subject.meshColostomy - instrumentation-
dc.subject.meshIntestinal Obstruction - etiology - mortality - radiography - surgery-
dc.subject.meshProsthesis Implantation - instrumentation-
dc.titleSelf-expanding metallic stent in the treatment of colonic obstruction caused by advanced malignanciesen_HK
dc.typeConference_Paperen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0012-3706&volume=43&issue=11&spage=1522&epage=1527&date=2000&atitle=Self-expanding+metallic+stent+in+the+treatment+of+colonic+obstruction+due+to+advanced+malignanciesen_HK
dc.identifier.emailLaw, SYK: slaw@hku.hken_HK
dc.identifier.emailChu, KM: chukm@hkucc.hku.hken_HK
dc.identifier.authorityLaw, SYK=rp00437en_HK
dc.identifier.authorityChu, KM=rp00435en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/BF02236731-
dc.identifier.pmid11089586-
dc.identifier.scopuseid_2-s2.0-0033692677en_HK
dc.identifier.hkuros56233en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0033692677&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume43en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1522en_HK
dc.identifier.epage1527en_HK
dc.identifier.isiWOS:000165209800007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWai Lun Law=7409517079en_HK
dc.identifier.scopusauthoridKin Wah Chu=7409811015en_HK
dc.identifier.scopusauthoridHo, JWC=7402649983en_HK
dc.identifier.scopusauthoridHiu Ming Tung=7409696355en_HK
dc.identifier.scopusauthoridLaw, SYK=7202241293en_HK
dc.identifier.scopusauthoridChu, KM=7402453538en_HK

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