Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan 10:2020:6810164.
doi: 10.1155/2020/6810164. eCollection 2020.

Endoscopic Self-Expandable Metallic Stent Insertion without Fluoroscopic Guidance Is Feasible and Safe for Acute Colonic Obstruction Caused by Colorectal Cancer

Yadong Feng  1 , Qian Yu  1 , Ming Li  1 , Wei Xu  1 , Ye Zhu  1 , Yang Liu  1 , Ruihua Shi  1
Affiliations

Endoscopic Self-Expandable Metallic Stent Insertion without Fluoroscopic Guidance Is Feasible and Safe for Acute Colonic Obstruction Caused by Colorectal Cancer

Yadong Feng et al. Gastroenterol Res Pract. .

Abstract

Aims: Endoscopic self-expandable metallic stent (SEMS) insertion for acute colonic obstruction caused by colorectal cancer (CRC) is always performed under fluoroscopic guidance. This study evaluated the feasibility and safety of an endoscopic stenting procedure without fluoroscopic guidance.

Methods: A total of 36 patients with an acute colonic obstruction caused by CRC underwent endoscopic SEMS insertion using a colonoscope without fluoroscopic guidance, followed by analyses of the technical and clinical success and short-term complications.

Results: Total technical success rate and clinical success rate were 91.7% and 86.1%, respectively. The mean procedure time was 21.2 ± 10.3 minutes. There was no stent dislodgement. One case of hematochezia and two cases of tenesmus occurred in patients with left-sided complete obstructions. No other short-term complications occurred. Procedure time, technical success, and clinical success rate were 16.3 ± 9.4 minutes, 93.1%, and 89.6% for left-sided obstructions, respectively, and were 26.8 ± 10.7 minutes, 85.7%, and 71.4% for right-sided obstructions, respectively. For complete obstructions, procedure time, technical success, and clinical success rate were 22.5 ± 8.9 minutes, 90%, and 83.3%, respectively. In the incomplete cases, procedure time, technical success, and clinical success were 13.5 ± 6.7 minutes, 100%, and 100%, respectively. Technical success, clinical success, and short-term complications were not differed between lesion locations and degrees.

Conclusions: This simple technique is feasible and safe for palliation of acute colonic obstruction caused by CRC.

PubMed Disclaimer

Conflict of interest statement

All authors declare there is no conflict of interest.

Figures

Figure 1
Figure 1
The procedures of one SEMS insertion. (a) Endoscopic view of a complete colonic malignant obstruction. (b) A hydrophilic 0.035-inch biliary guidewire was used to traverse the stricture. (c) The delivery system was advanced over the guidewire and guided into the site of obstruction. (d) Endoscopic view of stent release. (e) Endoscopic view of SEMS expansion after release. (f) The distal end of SEMS was about 2 cm beyond the edge of the tumor after stent deployment.
See this image and copyright information in PMC

References

    1. Schreuders E. H., Ruco A., Rabeneck L., et al. Colorectal cancer screening: a global overview of existing programmes. Gut. 2015;64(10):1637–1649. doi: 10.1136/gutjnl-2014-309086. - DOI - PubMed
    1. Papamichael D., Audisio R. A., Glimelius B., et al. Treatment of colorectal cancer in older patients: International Society of Geriatric Oncology (SIOG) consensus recommendations 2013. Annals of Oncology. 2015;26(3):463–476. doi: 10.1093/annonc/mdu253. - DOI - PubMed
    1. Arezzo A., Passera R., Lo Secco G., et al. Stent as bridge to surgery for left-sided malignant colonic obstruction reduces adverse events and stoma rate compared with emergency surgery: results of a systematic review and meta-analysis of randomized controlled trials. Gastrointestinal Endoscopy. 2017;86(3):416–426. doi: 10.1016/j.gie.2017.03.1542. - DOI - PubMed
    1. Davila R. E., Rajan E., Adler D., et al. ASGE guideline: the role of endoscopy in the diagnosis, staging, and management of colorectal cancer. Gastrointestinal Endoscopy. 2005;61(1):1–7. doi: 10.1016/s0016-5107(04)02391-0. - DOI - PubMed
    1. Young C. J., De-loyde K. J., Young J. M., et al. Improving quality of life for people with incurable large-bowel obstruction: randomized control trial of colonic stent insertion. Diseases of the Colon & Rectum. 2015;58(9):838–849. doi: 10.1097/DCR.0000000000000431. - DOI - PubMed

LinkOut - more resources