Skip to main content

Advertisement

SpringerLink
Log in

Self-expanding metal stenting for obstructing left colon cancer: A district hospital experience

  • Short Report
  • Published:
Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Stenting of malignant colonic obstructions using self-expanding metal stents (SEMS) is commonly used for palliation and can be used as an interim procedure prior to definitive surgery. We retrospectively reviewed prospectively collected data from all consecutive colonic stenting procedures undertaken between September 2007 and December 2014 at a district general hospital. Technical and clinical success rates, mortality, colonic perforation, and other complications were documented and analyzed. Sixty-four colonic stenting procedures were undertaken. Fifty-three (83 %) were for palliation and eleven (17 %) were performed as a bridge to definitive surgery. Technical (98.4 %) and clinical (89.9 %) success rates were excellent. The single documented failure was secondary to complete luminal obstruction. Three stent occlusions (4.6 %), one colonic perforation (1.5 %), and one migration were encountered. There were no procedure-related deaths. Colonic stenting for obstructing left-sided colon cancer is a safe and effective procedure, even in the district general hospital setting. The use of SEMS as a bridge to elective surgery balances surgical and oncological considerations and, therefore, is most appropriate for high surgical risk patients in this setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bonin EA, Baron TH. Update on the indications and use of colonic stents. Curr Gastroenterol Rep. 2010;12:374–82.

    Article  PubMed  Google Scholar 

  2. Jiménez-Pérez J, Casellas J, García-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.

    Article  PubMed  Google Scholar 

  3. Rupp KD, Dohmoto M, Meffert R, Holzgreve A, Hohlbach G. Cancer of the rectum—palliative endoscopic treatment. Eur J Surg Oncol. 1995;2:644–7.

    Article  Google Scholar 

  4. Smothers L, Hynan L, Fleming J, Turnage R, Simmang C, Anthony T. Emergency surgery for colon carcinoma. Dis Colon Rectum. 2003;46:24–30.

  5. Cirocchi R, Farinella E, Trastulli S, et al. Safety and efficacy of endoscopic colonic stenting as a bridge to surgery in the management of intestinal obstruction due to left colon and rectal cancer: a systematic review and meta-analysis. Surg Oncol. 2012;22:14–21.

    Article  PubMed  Google Scholar 

  6. Watt AM, Faragher IG, Griffin TT, Rieger NA, Maddern GJ. Self-expanding metallic stents for relieving malignant colorectal obstruction: a systematic review. Ann Surg. 2007;246:24–30.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Al-Jundi W, Kadam S, Giagtzidis I, et al. Self-expanding metal stenting for malignant colonic tumours: a prospective study. Surg Sci. 2011;2:151.

    Article  Google Scholar 

  8. Rosario BH, Hurlstone P, Lee F, Downes T. Colonic stenting: an alternative to surgery in the elderly. Age Ageing. 2007;36:593–5.

    Article  PubMed  Google Scholar 

  9. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Jullumstrø E, Wibe A, Lydersen S, Edna TH. Colon cancer incidence, presentation, treatment and outcomes over 25 years. Colorectal Dis. 2011;13:512–8.

  11. Cheynel N, Cortet M, Lepage C, Benoit L, Faivre J, Bouvier AM. Trends in frequency and management of obstructing colorectal cancers in a well-defined population. Dis Colon Rectum. 2007;50:1568–75.

  12. Frago R, Ramirez E, Millan M, Kreisler E, del Valle E, Biondo S. Current management of acute malignant large bowel obstruction: a systematic review. Am J Surg. 2014;207:127–38.

    Article  PubMed  Google Scholar 

  13. 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.

    Article  PubMed  Google Scholar 

  14. Zhao XD, Cai BB, Cao RS, Shi RH. Palliative treatment for incurable malignant colorectal obstructions: a meta-analysis. World J Gastroenterol. 2013;19:5565–74.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Khot UP, Lang AW, Murali K, Parker MC. Systematic review of the efficacy and safety of colorectal stents. Br J Surg. 2002;89:1096–102.

    Article  CAS  PubMed  Google Scholar 

  16. Keymling M. Colorectal stenting. Endoscopy. 2003;35:234–8.

    Article  CAS  PubMed  Google Scholar 

  17. Sebastian S, Johnston S, Geoghegan T, Torreggiani W, Buckley M. Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction. Am J Gastroenterol. 2004;99:2051–7.

    Article  PubMed  Google Scholar 

  18. 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.

    Article  PubMed  Google Scholar 

  19. Campbell KL, Hussey JK, Eremin O. Expandable metal stent application in obstructing carcinoma of the proximal colon: report of a case. Dis Colon Rectum. 1997;40:1391–3.

  20. Xinopoulos D, Dimitroulopoulos D, Theodosopoulos T, et al. Stenting or stoma creation for patients with inoperable malignant colonic obstructions? Results of a study and cost-effectiveness analysis. Surg Endosc Other Interv Tech. 2004;18:421–6.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General and Colorectal Surgery, Queen Elizabath The Queen Mother Hospital, Margate, CT9 4AN, UK

    Mohan Raj Harilingam

  2. Department of General and Vascular Surgery, Kent and Canterbury Hospital, Ethelbert Road, Canterbury, CT1 3NG, UK

    Amjad Khushal & Abdulmalik Aikoye

Authors
  1. Mohan Raj Harilingam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amjad Khushal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abdulmalik Aikoye
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohan Raj Harilingam.

Ethics declarations

Conflict of interest

MRH, AK, and AA declare that they have no competing interests.

Ethics statement

The study was performed in a manner to conform to the Helsinki Declaration of 1975, as revised in 2000 and 2008, concerning human and animal rights, and the authors followed the policy concerning informed consent as shown in springer.com.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Harilingam, M.R., Khushal, A. & Aikoye, A. Self-expanding metal stenting for obstructing left colon cancer: A district hospital experience. Indian J Gastroenterol 35, 305–309 (2016). https://doi.org/10.1007/s12664-016-0671-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12664-016-0671-y

Keywords

Search

Navigation