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

Autor: S. Ferrer, Pierre Mambrini, Alessandro Repici, Luis Andreo, Diego Fregonese, Søren Meisner, Guido Costamagna, Enzo Masci, Juan Gallego, Alberto Mingo, Remi Dumas, Marcello Campaioli, Alfredo Lopez Morante, Riccardo Naspetti, J Barcenilla, Lucio Petruzziello
Rok vydání: 2007
Předmět:
Zdroj: Gastrointestinal endoscopy. 67(1)
ISSN: 0016-5107
Popis: 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.
Databáze: OpenAIRE
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