BACKGROUND: Self-expandable metal stents are an alternative to preoperative and palliative colostomy for patients with malignant colorectal obstruction. However, self-expandable metal stent placement is considered unsuitable or contraindicated for patients with malignant lower rectal obstruction within 5 cm of the anal verge because the exposed stent portion can irritate the distal rectum and cause anal pain and a foreign body sensation.
OBJECTIVE: To describe our experience with 6 patients with malignant lower rectal obstruction who underwent stent insertion with a proximal releasing delivery system (PRDS).
DESIGN: Prospective clinical series outcome study.
SETTING: A tertiary-care referral university hospital.
PATIENTS: This study involved all patients at our center who had a malignant lower rectal obstruction within 5 cm of the anal verge caused by rectal cancer and bladder cancer.
INTERVENTION: Uncovered stent with the PRDS with endoscopic and fluoroscopic guidance.
MAIN OUTCOME MEASUREMENTS: Technical and clinical success rate, adverse event rate, and stent migration rate.
RESULTS: All stents were placed at the expected location. Technical and clinical success rates were 100%. Two patients reported anal pain, which was controlled with analgesics. One case of tumor ingrowth occurred after 5 months and was treated with reinsertion of a stent with the PRDS. After stent insertion, the patients received chemotherapy, chemoradiotherapy, or conservative care.
LIMITATIONS: Small number of patients and no comparison group. Further prospective, randomized, controlled trials are needed.
CONCLUSIONS: Uncovered stent insertion with the PRDS is a feasible, safe, and effective treatment for the patient with malignant lower rectal obstruction within 5 cm from the anal verge.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.
Total Visit :7,549,380
Total Download :3,209,094
Today View :1,786
Ajou University Medical Information & Media Center 164 Worldcup-ro Yeongtong-gu Suwon 16499 Korea / TEL : 031-219-5312 / FAX : 031-219-5314 Copyright (c) Ajou University Medical Information & Media Center All Rights Reserved. AJOU Open Repository는 국립중앙도서관 OAK 보급사업으로 구축되었습니다.