Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 28, 2011; 17(28): 3342-3346
Published online Jul 28, 2011. doi: 10.3748/wjg.v17.i28.3342
Self-expanding metallic stents drainage for acute proximal colon obstruction
Li-Qin Yao, Yun-Shi Zhong, Mei-Dong Xu, Jian-Min Xu, Ping-Hong Zhou, Xian-Li Cai
Li-Qin Yao, Yun-Shi Zhong, Mei-Dong Xu, Jian-Min Xu, Ping-Hong Zhou, Xian-Li Cai, Department of Endoscopic Center, Zhongshan Hospital, Fudan University Medical Center, Shanghai 200032, China
Author contributions: Yao LQ designed the study; Zhong YS, Xu MD, Cai XL and Zhou PH performed endoscopic examinations: Zhong YS and Cai XL did the data analysis and wrote the manuscript; Xu JM performed the operation.
Supported by Shanghai Science and Technology Committee, No. 09411967100; Shanghai Municipal Health Bureau, No. 2007Y38
Correspondence to: Dr. Yun-Shi Zhong, Department of Endoscopic Center, Zhongshan Hospital, Fudan University Medical Center, Shanghai 200032, China. zhong780124@sina.com.cn
Telephone: +86-21-64041990 Fax: +86-21-64038038
Received: October 16, 2010
Revised: February 26, 2011
Accepted: March 5, 2011
Published online: July 28, 2011
Abstract

AIM: To clarify the usefulness of the self-expanding metallic stents (SEMS) in the management of acute proximal colon obstruction due to colon carcinoma before curative surgery.

METHODS: Eighty-one colon (proximal to spleen flex) carcinoma patients (47 males and 34 females, aged 18-94 years, mean = 66.2 years) treated between September 2004 and June 2010 for acute colon obstruction were enrolled to this study, and their clinical and radiological features were reviewed. After a cleaning enema was administered, urgent colonoscopy was performed. Subsequently, endoscopic decompression using SEMS placement was attempted.

RESULTS: Endoscopic decompression using SEMS placement was technically successful in 78 (96.3%) of 81 patients. Three patients’ symptoms could not be relieved after SEMS placement and emergent operation was performed 1 d later. The site of obstruction was transverse colon in 18 patients, the hepatic flex in 42, and the ascending colon in 21. Following adequate cleansing of the colon, patients’ abdominal girth was decreased from 88 ± 3 cm before drainage to 72 ± 6 cm 7 d later, and one-stage surgery after 8 ± 1 d (range, 7-10 d) was performed. No anastomotic leakage or postoperative stenosis occurred after operation.

CONCLUSION: SEMS placement is effective and safe in the management of acute proximal colon obstruction due to colon carcinoma, and is considered as a bridged method before curative surgery.

Keywords: Endoscope; Proximal colon cancer; Obstruction; Self-expanding metallic stents; Drainage