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Colonic Stent: Bridge to Surgery

  • Yoshihisa SaidaEmail author
Chapter

Abstract

Colonic stent (SEMS: self-expandable metallic stent) treatment for malignant colonic obstruction is one of the standard endoscopic treatments and has been available in Japan since 2012. In this review, the present conditions and future prospects of the procedure are described based on data from the literature. The current indication is malignant colorectal stenosis. Stent use in palliative treatment, avoidance of colostomy, release of obstruction, shorter duration of hospitalization, and better quality of life have been widely reported. Moreover, stent use can be a bridge to surgery (BTS), enabling shorter duration of hospitalization and reduced postoperative complications, colostomy rates, and mortality rates compared to emergency surgery. However, the evidence concerning patients’ long-term prognosis is still lacking. Although the reported complication rate is low, adequate preparation and informed consent are important because complications can still occur.

Keywords

Colonic stent Colorectal obstruction Palliative treatment Bridge to surgery Colorectal Obstruction Scoring System 

References

  1. 1.
    Phillips RK, Hittinger R, Fry JS, Fielding LP. Malignant large bowel obstruction. Br J Surg. 1985;72:296–302.CrossRefGoogle Scholar
  2. 2.
    Winner M, Mooney SJ, Hershman DL, et al. Incidence and predictors of bowel obstruction in elderly patients with stage IV colon cancer: a population-based cohort study. JAMA Surg. 2013;148:715–22.CrossRefGoogle Scholar
  3. 3.
    Jullumstro E, Wibe A, Lydersen S, et al. Colon cancer incidence, presentation, treatment and outcomes over 25 years. Color Dis. 2011;13:512–8.CrossRefGoogle Scholar
  4. 4.
    Cheynel N, Cortet M, Lepage C, et al. Trends in frequency and management of obstructing colorectal cancers in a well-defined population. Dis Colon Rectum. 2007;50:1568–75.CrossRefGoogle Scholar
  5. 5.
    Hasegawa K, Sugihara K, Enomoto M, et al. A study of obstructive colorectal cancer. Jpn J Gastroenterol Surg. 2000;33:709–15 (in Japanese).CrossRefGoogle Scholar
  6. 6.
    Kamigaki T, Shimada E, Urakawa T. A clinicopathological study of colorectal cancer with bowel obstruction. Jpn J Gastroenterol Surg. 1993;26:76–81 (in Japanese).CrossRefGoogle Scholar
  7. 7.
    Yang Z, Wang L, Kang L, et al. Clinicopathologic characteristics and outcomes of patients with obstructive colorectal cancer. J Gastrointest Surg. 2011;15:1213–22.CrossRefGoogle Scholar
  8. 8.
    Saida Y. A review of colonic stents. Gastroenterol Endosc. 2013;55: 3–11 (in Japanese).Google Scholar
  9. 9.
    Barillari P, Aurello P, De Angelis R, et al. Management and survival of patients affected with obstructive colorectal cancer. Int Surg. 1992;77:251–5.PubMedGoogle Scholar
  10. 10.
    Saida Y, Sumiyama Y, Nagao J, et al. Stent endoprosthesis for obstructing colorectal cancers. Dis Colon Rectum. 1996;39:552–5.CrossRefGoogle Scholar
  11. 11.
    Lelcuk S, Ratan J, Klausner JM, et al. Endoscopic decompression of acute colonic obstruction. Avoiding staged surgery. Ann Surg. 1986;203:292–4.CrossRefGoogle Scholar
  12. 12.
    Li CY, Guo SB, Wang NF. Decompression of acute left-sided malignant colorectal obstruction: comparing transanal drainage tube with metallic stent. J Clin Gastroenterol. 2014;48:e37–42.PubMedGoogle Scholar
  13. 13.
    Dohmoto M. New method: endoscopic implantation of rectal stent in palliative treatment of malignant stenosis. Endosc Dig. 1991;3:1507–12.Google Scholar
  14. 14.
    Trompetas V. Emergency management of malignant acute left-sided colonic obstruction. Ann R Coll Surg Engl. 2008;90:181–6.CrossRefGoogle Scholar
  15. 15.
    ASGE Standards of Practice Committee, Harrison ME, Anderson MA, et al. The role of endoscopy in the management of patients with known and suspected colonic obstruction and pseudo-obstruction. Gastrointest Endosc. 2010;71:669–79.CrossRefGoogle Scholar
  16. 16.
    Ansaloni L, Andersson RE, Bazzoli F, et al. Guidelines in the management of obstructing cancer of the left colon: consensus conference of the world society of emergency surgery (WSES) and peritoneum and surgery (PnS) society. World J Emerg Surg. 2010;28:29.CrossRefGoogle Scholar
  17. 17.
    Matsuzawa T, Ishida H, Yoshida S, et al. A Japanese prospective multicenter study of self-expandable metal stent placement for malignant colorectal obstruction: short-term safety and efficacy within 7 days of stent procedure in 513 cases. Gastrointest Endosc. 2015;82:697–707.CrossRefGoogle Scholar
  18. 18.
    Amelung FJ, Consten ECJ, Siersema PD, et al. A population-based analysis of three treatment modalities for malignant obstruction of the proximal colon: acute resection versus stent or stoma as a bridge to surgery. Ann Surg Oncol. 2016;23:3660–8.CrossRefGoogle Scholar
  19. 19.
    Watt AM, Faragher IG, Griffin TT, et al. Self-expanding metallic stents for relieving malignant colorectal obstruction: a systematic review. Ann Surg. 2007;246:24–30.CrossRefGoogle Scholar
  20. 20.
    Jimenez-Perez J, Casellas J, Garcia-Cano J, et al. Colonic stenting as a bridge to surgery in malignant large-bowel obstruction: a report from two large multinational registries. Am J Gastroenterol. 2011;106:2174–80.CrossRefGoogle Scholar
  21. 21.
    Zhang Y, Shi J, Shi B, et al. Self-expanding metallic stent as a bridge to surgery versus emergency surgery for obstructive colorectal cancer: a meta-analysis. Surg Endosc. 2012;26:110–9.CrossRefGoogle Scholar
  22. 22.
    Saida Y, Sumiyama Y, Nagao J, et al. Long-term prognosis of preoperative “bridge to surgery” expandable metallic stent insertion for obstructive colorectal cancer: comparison with emergency operation. Dis Colon Rectum. 2003;46:s44–9.PubMedGoogle Scholar
  23. 23.
    Tilney S, Lovegrove RE, Purkayastha S, et al. Comparison of colon stenting and open surgery for malignant large bowel obstruction. Surg Endosc. 2007;21:225–33.CrossRefGoogle Scholar
  24. 24.
    Sabbagh C, Browet F, Diouf M, et al. Is stenting as “a bridge to surgery” an oncologically safe strategy for the management of acute, left-sided, malignant, colonic obstruction?: a comparative study with a propensity score analysis. Ann Surg. 2013;258:107–15.CrossRefGoogle Scholar
  25. 25.
    van Hooft JE, van Halsema EE, Vanbiervliet G, et al. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2014;46:990–1053.CrossRefGoogle Scholar
  26. 26.
    Arezzo A, Balague C, Targarona E, et al. Colonic stenting as a bridge to surgery versus emergency surgery for malignant colonic obstruction: results of a multicentre randomised controlled trial (ESCO trial). Surg Endosc. 2017;31:3297–305.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of SurgeryToho University Ohashi Medical CenterTokyoJapan

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