Ultraflex precision colonic stent placement as a bridge to surgery in patients with malignant colon obstruction

被引:52
作者
Fregonese, Diego [1 ]
Naspetti, Riccardo [2 ]
Ferrer, Salvador [3 ]
Gallego, Juan [4 ]
Costamagna, Guido [5 ]
Dumas, Remi [6 ]
Campaioli, Marcello [7 ]
Morante, Alfredo Lopez [8 ]
Mambrini, Pierre [9 ]
Meisner, Soren [10 ]
Repici, Alessandro [11 ]
Andreo, Luis [12 ]
Masci, Enzo [13 ]
Mingo, Alberto [14 ]
Barcenilla, Javier [15 ]
Petruzziello, Lucio [5 ]
机构
[1] Osped Camposampiero, Dipartimento Chirurg, Via P Cosma 1, I-35012 Camposampiero, PD, Italy
[2] Univ Careggi, Azienda Osped, Florence, Italy
[3] Hosp Gen Valencia, Serv Radiol, Valencia, Spain
[4] Hosp Clin San Carlos, Madrid, Spain
[5] Univ Cattolica Sacro Cuore, Policlin Agostino Gemelli, Rome, Italy
[6] Ctr Hosp Univ Nice, Nice, France
[7] Presidio Osped Misericordia & Dolce, Sez Gastroenterol & Endoscopia Digest, Prato, Italy
[8] Hosp Gen Yague, Serv Digest, Burgos, Spain
[9] Clin Golfe, Ajaccio, France
[10] HS Bispebjerg Hosp, Copenhagen, Denmark
[11] Osped San Giovanni Battista Torino, Turin, Italy
[12] Hosp Virgen Lirios, Alicante, Spain
[13] Univ Milan, Osped San Raffaele, Div Endoscopia, I-20127 Milan, Italy
[14] Hosp Univ Princesa, Madrid, Spain
[15] Hosp Gen Rio Carrion, Palencia, Spain
关键词
D O I
10.1016/j.gie.2007.05.022
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Emergency surgery for malignant colon obstruction entails relatively high morbidity and mortality rates and typically necessitates a 2-step resection. These problems might be potentially mitigated by placement of a self-expanding metal stent (SEMS) as a bridge to surgery. A nitinol colorectal SEMS may offer several advantages, but available evidence on the utility of this SEMS type remains highly limited. Objective: Our purpose was to evaluate the effectiveness and safety as a bridge to surgery of a nitinol SEMS designed for colorectal use. Design: Prospective and retrospective multicenter clinical study. Setting: Sixteen European study centers. Patients: Thirty-six patients with malignant colonic obstruction. Interventions: Nitinol colorectal SEMS placement. Main Outcome Measures: Technical success in accurate SEMS placement with coverage of the entire stricture length, clinical success in alleviating colonic obstructive symptoms, and bridging to elective surgery. Results: Technical success was achieved in 97% of patients with a 95% CI of 85% to 100% and clinical success in 81% (95% CI, 64%-92%). Elective surgery was performed in 94% (95% CI, 81%-99%) of patients at a median of 11 days (95% CI, 7-15 days) after SEMS placement. SEMS-related perforation occurred in 3 patients. Limitations: No control group was included in this nonrandomized cohort study. Conclusions: In this first comparatively large clinical study of a nitinol colorectal SEMS as a bridge to surgery, a high proportion of patients successfully proceeded to elective surgery after prior decompression by SEMS placement.
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收藏
页码:68 / 73
页数:6
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