Preoperative Endoscopic Stent Application for Bridging or Palliative Purposes in Obstructive Left Colon and Rectal Tumors

Objective: The outcomes of endoscopic enteral stent applications in left colon or rectal cancers were evaluated. Methods: All patients who received stent application between January 2016 and December 2017 for obstructive left colon and rectal cancers were retrospectively evaluated. Demographic data, obstructed side, indications, technical and clinical success of the procedure, and also mortality and morbidity rates were recorded. Results: Stents were successfully placed in 12 (85.7%) out of 14 cases. Eight cases received stents for bridge to elective surgery, whereas four had stents for palliative purposes. In one of the palliative cases, Hartman procedure was applied due to perforation at the proximal side of the stent after 3 months. The technical and clinical success rates were 85.7% and 91.7%, respectively. There was no mortality. Conclusion: Application of self-expanding metallic stent in patients with advanced stage obstructive colorectal cancer may be an alternative method compared with emergency surgeries. It can be safely and effectively performed and offers opportunities for palliative treatments and elective surgeries.

Obstrüktif Sol Kolon ve Rektum Kanserinde Ameliyat Öncesi Köprüleme ya da Palyasyon Amaçlı Endoskopik Stent Uygulaması

Amaç: Obstrüktif sol kolon ve rektum kanseri nedeniyle endoskopik bağırsak stent uyguladığımız hastaların sonuçlarını değerlendirmektir. Gereç ve Yöntem: Ocak 2016–Aralık 2017 tarihleri arasında obstrüktif sol kolon ve rektum tümörü nedeniyle endoskopik stent girişiminde bulunulan hastalar geriye dönük olarak irdelendi. Hastaların demografik özellikleri, ostrüksiyonun lokalizasyonu, endikasyon, uygulamanın teknik ve klinik başarısıyla birlikte mortalite ve morbidite oranları değerlendirildi. Bulgular: Stent uygulaması planlanan 14 hastanın 12’sinde başarı sağlandı (%85.7). Olguların sekizine elektif ameliyat için köprüleme, dördüne ise palyasyon amaçlı stent yerleştirildi. Palyatif amaçlı stentleme yapılan bir hasta stent uygulamasından üç ay sonra stentin proksimalinden perfore olduğu gözlendi ve bu hastaya Hartmann ameliyatı yapıldı. Teknik ve klinik başarı oranımız sırasıyla %85.7 ve %91.7 idi. Stent uygulamasına bağlı mortalite gözlenmedi. Sonuç: Kendiliğinden genişleyen metalik stent (SEMS) uygulaması ileri evre obstrüktif kolorektal tümörü olan hastalara gerek palyatif tedavi gerekse de elektif küratif cerrahi şansı vermesi nedeniyle acil cerrahi girişimlere alternatif güvenli ve etkili bir tedavi metodu olarak görülmektedir.

Kaynakça

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Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

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