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Colorectal Stenting as Bridge to Surgery

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Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy

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Abstract

Colorectal cancer is one of the most frequent cancers worldwide and represents the most common cause of colon obstruction. Historically, the treatment of acute neoplastic obstruction is represented by a surgical resection in an emergency context, an approach with a high risk of postoperative complications and mortality. Recently, the use of a colonic stent, endoscopically released to overcome obstruction, has been proposed. The purpose of colon stenting is to transform a case that has required emergency surgery into an elective surgical case. It aims to reduce morbidity, mortality, and stoma creation. However, concern was raised about the long-term survival and cancer safety of this new approach, so the European Society for Gastrointestinal Endoscopy initially did not recommend the stent as a bridge to surgery as a standard treatment in left colon obstruction. But recent scientific evidence has shown that this approach is effective and safe as it reduces postoperative complications, the stoma rate without differences in cancer outcomes compared to emergency surgery. Therefore, the European Society for Gastrointestinal Endoscopy in their latest update has reconsidered stenting as a bridge to surgery as a valid alternative to emergency surgery.

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Authors and Affiliations

  1. Department of Surgical Sciences, University of Torino, Turin, Italy

    Edoardo Forcignanò, Francesca Currado, Giacomo Lo Secco & Alberto Arezzo

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  1. Edoardo Forcignanò
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  2. Francesca Currado
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  3. Giacomo Lo Secco
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  4. Alberto Arezzo
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Correspondence to Alberto Arezzo .

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Editors and Affiliations

  1. Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, MILANO, Milano, Italy

    Pier Alberto Testoni

  2. Digestive Diseases Center, Showa University Hospital, Tokyo, Japan

    Haruhiro Inoue

  3. Div. of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA

    Michael B. Wallace

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  1. Cancer Center, Mayo Clinic, Jacksonville, FL, USA

    Michael B. Wallace

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Forcignanò, E., Currado, F., Lo Secco, G., Arezzo, A. (2021). Colorectal Stenting as Bridge to Surgery. In: Testoni, P.A., Inoue, H., Wallace, M.B. (eds) Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-29964-4_58-1

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