Abstract
Background
The application of stents in benign colorectal strictures is considered controversial. The aim of the present study was to assess effectiveness and complications associated with colorectal stent placement in benign colorectal disease.
Patients and methods
Fourteen patients with benign colorectal strictures who had undergone previous surgery (colorectal anastomotic stenosis, 13; neosphincter scar stenosis, one) were treated with covered self-expanding metal stent or plastic stent. Placement of the stent was performed with combined endoscopy and contrast enhanced fluoroscopy.
Results
Self-expanding stents were successful implanted in all 14 patients without acute procedure-related complications. All patients experienced immediate decompression after stent placement with expansion and patency of the stent. Relief of bowel obstruction for at least 12 months was achieved in seven of 14 patients (50%). Anastomotic fistula healed in four of six patients (67%). Despite the initial success of stenting, re-operations had to be performed in two of seven patients because of late recurrence of the stricture after a mean follow-up of 37 months.
Conclusions
Temporary insertion of self-expanding stents is a safe procedure that may be effective in selected cases of benign colorectal stricture. However, repeat surgery will be necessary in a considerable number of patients due to primary or secondary failure of stenting.
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References
Hünerbein M, Krause M, Moesta KT, Rau B, Schlag PM (2005) Palliation of malignant rectal obstruction with self-expanding metal stents. Surgery 137(1):42–47
Suarez J, Jimenez J, Vera R, Tarifa A, Balen E, Arrazubi V, Vila J, Lera JM (2009) Stent or surgery for incurable obstructive colorectal cancer: an individualized decision. Int J Colorectal Dis 25(1):91–96. doi:10.1007/s00384-009-0814-z
Baron TH, Dean PA, Yates MR 3rd, Canon C, Koehler RE (1998) Expandable metal stents for the treatment of colonic obstruction: techniques and outcomes. Gastrointest Endosc 47(3):277–286
Tomiki Y, Watanabe T, Ishibiki Y, Tanaka M, Suda S, Yamamoto T, Sakamoto K, Kamano T (2004) Comparison of stent placement and colostomy as palliative treatment for inoperable malignant colorectal obstruction. Surg Endosc 18(11):1572–1577
Geiger TM, Miedema BW, Tsereteli Z, Sporn E, Thaler K (2008) Stent placement for benign colonic stenosis: case report, review of the literature, and animal pilot data. Int J Colorectal Dis 23(10):1007–1012
Wholey MH, Levine EA, Ferral H, Castaneda-Zuniga W (1998) Initial clinical experience with colonic stent placement. Am J Surg 175(3):194–197
Tarquinio L, Zimmerman MJ (2000) Successful treatment of a benign anastomotic stricture despite stent migration. Gastrointest Endosc 52(3):436–438
Adamsen S, Holm J, Meisner S, Moller P, Naver LP, Wille-Jorgensen PA (2000) [Endoscopic treatment of colorectal obstruction with self-expandable metal endoprosthesis]. Ugeskr Laeger 162(11):1560–1563
Tamim WZ, Ghellai A, Counihan TC, Swanson RS, Colby JM, Sweeney WB (2000) Experience with endoluminal colonic wall stents for the management of large bowel obstruction for benign and malignant disease. Arch Surg 135(4):434–438
Odurny A (2001) Colonic anastomotic stenoses and Memotherm stent fracture: a report of three cases. Cardiovasc Interv Radiol 24(5):336–339
Luchtefeld MA, Milsom JW, Senagore A, Surrell JA, Mazier WP (1989) Colorectal anastomotic stenosis. Results of a survey of the ASCRS membership. Dis Colon Rectum 32(9):733–736
Werre A, Mulder C, van Heteren C, Bilgen ES (2000) Dilation of benign strictures following low anterior resection using Savary-Gilliard bougies. Endoscopy 32(5):385–388
Johansson C (1996) Endoscopic dilation of rectal strictures: a prospective study of 18 cases. Dis Colon Rectum 39(4):423–428
Suchan KL, Muldner A, Manegold BC (2003) Endoscopic treatment of postoperative colorectal anastomotic strictures. Surg Endosc 17(7):1110–1113
Wadhwa RP, Kozarek RA, France RE, Brandabur JJ, Gluck M, Low DE, Traverso LW, Moonka R (2003) Use of self-expandable metallic stents in benign GI diseases. Gastrointest Endosc 58(2):207–212
Sandha GS, Marcon NE (1999) Expandable metal stents for benign esophageal obstruction. Gastrointest Endosc Clin N Am 9(3):437–446
Raijman I (1999) The wallstent for benign biliary obstruction. Gastrointest Endosc Clin N Am 9(3):521–531
Rayhanabad J, Abbas MA (2009) Long-term outcome of endoscopic colorectal stenting for malignant and benign disease. Am Surg 75(10):897–900
Khot UP, Lang AW, Murali K, Parker MC (2002) Systematic review of the efficacy and safety of colorectal stents. Br J Surg 89(9):1096–1102
Clark JS, Buchanan GN, Khawaja AR, Rowe PH, Stoodley BJ, Saunders MP, Anderson HJ (2003) Use of the bard memotherm self-expanding metal stent in the palliation of colonic obstruction. Abdom Imaging 28(4):518–524
Binkert CA, Ledermann HP, Jost R, Zollikofer CL (1998) Metallic stenting of gastroduodenal and colonic stenoses. Abdom Imaging 23(6):580–586
Alvi A, Pitt JP (2009) A case of entero-colic fistula formation resulting from stent migration inserted for obstructing left colonic tumour. Int J Colorectal Dis 24(3):353
Song HY, Park SI, Do YS, Yoon HK, Sung KB, Sohn KH, Min YI (1997) Expandable metallic stent placement in patients with benign esophageal strictures: results of long-term follow-up. Radiology 203(1):131–136
Oz MC, Forde KA (1990) Endoscopic alternatives in the management of colonic strictures. Surgery 108(3):513–519
Small AJ, Young-Fadok TM, Baron TH (2008) Expandable metal stent placement for benign colorectal obstruction: outcomes for 23 cases. Surg Endosc 22(2):454–462
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Dai, Y., Chopra, S.S., Wysocki, W.M. et al. Treatment of benign colorectal strictures by temporary stenting with self-expanding stents. Int J Colorectal Dis 25, 1475–1479 (2010). https://doi.org/10.1007/s00384-010-1038-y
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DOI: https://doi.org/10.1007/s00384-010-1038-y