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 27 May 2018

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News

Preoperative metallic stents for patients with acute malignant colorectal obstruction

Preoperative stent insertion is a reliable alternative to emergency surgery in patients with acute malignant colorectal obstruction, claims a team from Augsburg, Germany.

News image

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The researchers evaluated preoperative decompression with self-expanding metallic stents in patients with acute bowel obstruction due to colorectal carcinoma.

They wanted to assess whether this technique could be an alternative to emergency surgery.

The study's findings were reported in the German journal, Der Chirurg.

Some 28 patients were admitted to the team's clinic between January 1996 and May 1999, with suspicion of acute colonic obstruction caused by a colorectal carcinoma.

Insertion of a self-expanding metallic stent in the stenosis, under fluoroscopic control, was attempted in the subjects.

19/21 patients experienced symptom relief within 2 days.
Der Chirurg

An elective one-stage surgical procedure followed successful relief of obstruction.

The stent insertion was technically successful in 21 patients.

In 19 patients, symptom relief was reached within 2 days. One of these patients died perioperatively and 2 patients developed an anastomotic leak.

In 8 of the other 9 patients, in whom decompression was not possible, an emergency surgical procedure was performed; 4 of these patients died perioperatively.

A surgical procedure without an enterostoma was performed in only 1 of the 5 patients who survived.

Author E. Knöpfle, of the Augsburg Clinic, Germany, concluded on behalf of the group, "In cases of acute malignant colorectal obstruction, preoperative stent insertion under fluoroscopic control is a reliable method, which allows single-stage surgical resection without requiring a protective enterostoma."

Der Chirurg 2001; 72 (10): 1137-43
15 October 2001

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