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Novel method of stent insertion for malignant lower rectal obstruction with proximal releasing delivery system (with video).

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dc.contributor.authorLee, KM-
dc.contributor.authorLim, SG-
dc.contributor.authorShin, SJ-
dc.contributor.authorKim, JH-
dc.contributor.authorKang, DH-
dc.contributor.authorKim, JK-
dc.contributor.authorHwang, JC-
dc.contributor.authorKwon, CI-
dc.contributor.authorCheong, JY-
dc.contributor.authorYoo, BM-
dc.date.accessioned2014-05-15T01:45:43Z-
dc.date.available2014-05-15T01:45:43Z-
dc.date.issued2013-
dc.identifier.issn0016-5107-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/9967-
dc.description.abstractBACKGROUND: 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.
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dc.language.isoen-
dc.titleNovel method of stent insertion for malignant lower rectal obstruction with proximal releasing delivery system (with video).-
dc.typeArticle-
dc.identifier.pmid24237948-
dc.identifier.urlhttp://linkinghub.elsevier.com/retrieve/pii/S0016-5107(13)02301-8-
dc.subject.keywordPRDS-
dc.subject.keywordSEMS-
dc.subject.keywordproximal releasing delivery system-
dc.contributor.affiliatedAuthor이, 기명-
dc.contributor.affiliatedAuthor임, 선교-
dc.contributor.affiliatedAuthor신, 성재-
dc.contributor.affiliatedAuthor김, 진홍-
dc.contributor.affiliatedAuthor김, 재근-
dc.contributor.affiliatedAuthor황, 재철-
dc.contributor.affiliatedAuthor정, 재연-
dc.contributor.affiliatedAuthor유, 병무-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.gie.2013.08.018-
dc.citation.titleGastrointestinal endoscopy-
dc.citation.volume78-
dc.citation.number6-
dc.citation.date2013-
dc.citation.startPage930-
dc.citation.endPage933-
dc.identifier.bibliographicCitationGastrointestinal endoscopy, 78(6):930-933, 2013-
dc.identifier.eissn1097-6779-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
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