Expandable metal stents for the treatment of colonic obstruction: techniques and outcomes

被引:200
作者
Baron, TH
Dean, PA
Yates, MR
Canon, C
Koehler, RE
机构
[1] Univ Alabama, Med Ctr, Dept Med, Div Gastroenterol & Hepatol, Birmingham, AL 35294 USA
[2] Univ Alabama, Med Ctr, Dept Surg, Birmingham, AL 35294 USA
[3] Univ Alabama, Med Ctr, Dept Radiol, Birmingham, AL 35294 USA
关键词
D O I
10.1016/S0016-5107(98)70327-X
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Acute left-sided colonic obstruction is a surgical emergency whose management is controversial. Because experience using expandable metal stents for relief of this type of obstruction is limited, we evaluated their effectiveness, feasibility, safety, and outcome. Methods: Twenty-five patients with acute colorectal obstruction underwent placement of various metal stents under fluoroscopic and endoscopic guidance. On an intent-to-treat basis, stents were placed for decompression before one-stage surgical resection in 10 patients and palliatively in 15 patients. Two preoperative patients had unresectable malignant disease, and stents were left for palliation resulting in 17 palliative and 10 preoperative patients for analysis. Results: Stent placement was technically successful in 94% of patients. Overall effectiveness in relieving obstruction was 85% (palliative 82%, preoperative 90%). In the palliative group, stent duration ranged from 2 to 64 weeks (mean 17.3 weeks). Major complications occurred in 7 patients (30%). Conclusions: Expandable metal stents are a feasible, effective adjunct and alternative to surgery for acute colorectal obstruction.
引用
收藏
页码:277 / 286
页数:10
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