Top

International Journal of Colorectal Disease

Published in:

01-12-2010 | Original Article

Treatment of benign colorectal strictures by temporary stenting with self-expanding stents

Authors: YiYang Dai, Sascha S. Chopra, Wojciech M. Wysocki, Michael Hünerbein

Published in: International Journal of Colorectal Disease | Issue 12/2010

Abstract

Background

The application of stents in benign colorectal strictures is considered controversial. The aim of the present study was to assess effectiveness and complications associated with colorectal stent placement in benign colorectal disease.

Patients and methods

Fourteen patients with benign colorectal strictures who had undergone previous surgery (colorectal anastomotic stenosis, 13; neosphincter scar stenosis, one) were treated with covered self-expanding metal stent or plastic stent. Placement of the stent was performed with combined endoscopy and contrast enhanced fluoroscopy.

Results

Self-expanding stents were successful implanted in all 14 patients without acute procedure-related complications. All patients experienced immediate decompression after stent placement with expansion and patency of the stent. Relief of bowel obstruction for at least 12 months was achieved in seven of 14 patients (50%). Anastomotic fistula healed in four of six patients (67%). Despite the initial success of stenting, re-operations had to be performed in two of seven patients because of late recurrence of the stricture after a mean follow-up of 37 months.

Conclusions

Temporary insertion of self-expanding stents is a safe procedure that may be effective in selected cases of benign colorectal stricture. However, repeat surgery will be necessary in a considerable number of patients due to primary or secondary failure of stenting.

Hünerbein M, Krause M, Moesta KT, Rau B, Schlag PM (2005) Palliation of malignant rectal obstruction with self-expanding metal stents. Surgery 137(1):42–47CrossRefPubMed

Suarez J, Jimenez J, Vera R, Tarifa A, Balen E, Arrazubi V, Vila J, Lera JM (2009) Stent or surgery for incurable obstructive colorectal cancer: an individualized decision. Int J Colorectal Dis 25(1):91–96. doi:10.1007/s00384-009-0814-z CrossRefPubMed

Baron TH, Dean PA, Yates MR 3rd, Canon C, Koehler RE (1998) Expandable metal stents for the treatment of colonic obstruction: techniques and outcomes. Gastrointest Endosc 47(3):277–286CrossRefPubMed

Tomiki Y, Watanabe T, Ishibiki Y, Tanaka M, Suda S, Yamamoto T, Sakamoto K, Kamano T (2004) Comparison of stent placement and colostomy as palliative treatment for inoperable malignant colorectal obstruction. Surg Endosc 18(11):1572–1577PubMed

Geiger TM, Miedema BW, Tsereteli Z, Sporn E, Thaler K (2008) Stent placement for benign colonic stenosis: case report, review of the literature, and animal pilot data. Int J Colorectal Dis 23(10):1007–1012CrossRefPubMed

Wholey MH, Levine EA, Ferral H, Castaneda-Zuniga W (1998) Initial clinical experience with colonic stent placement. Am J Surg 175(3):194–197CrossRefPubMed

Tarquinio L, Zimmerman MJ (2000) Successful treatment of a benign anastomotic stricture despite stent migration. Gastrointest Endosc 52(3):436–438CrossRefPubMed

Adamsen S, Holm J, Meisner S, Moller P, Naver LP, Wille-Jorgensen PA (2000) [Endoscopic treatment of colorectal obstruction with self-expandable metal endoprosthesis]. Ugeskr Laeger 162(11):1560–1563PubMed

Tamim WZ, Ghellai A, Counihan TC, Swanson RS, Colby JM, Sweeney WB (2000) Experience with endoluminal colonic wall stents for the management of large bowel obstruction for benign and malignant disease. Arch Surg 135(4):434–438CrossRefPubMed

10.

Odurny A (2001) Colonic anastomotic stenoses and Memotherm stent fracture: a report of three cases. Cardiovasc Interv Radiol 24(5):336–339CrossRef

11.

Luchtefeld MA, Milsom JW, Senagore A, Surrell JA, Mazier WP (1989) Colorectal anastomotic stenosis. Results of a survey of the ASCRS membership. Dis Colon Rectum 32(9):733–736CrossRefPubMed

12.

Werre A, Mulder C, van Heteren C, Bilgen ES (2000) Dilation of benign strictures following low anterior resection using Savary-Gilliard bougies. Endoscopy 32(5):385–388CrossRefPubMed

13.

Johansson C (1996) Endoscopic dilation of rectal strictures: a prospective study of 18 cases. Dis Colon Rectum 39(4):423–428CrossRefPubMed

14.

Suchan KL, Muldner A, Manegold BC (2003) Endoscopic treatment of postoperative colorectal anastomotic strictures. Surg Endosc 17(7):1110–1113CrossRefPubMed

15.

Wadhwa RP, Kozarek RA, France RE, Brandabur JJ, Gluck M, Low DE, Traverso LW, Moonka R (2003) Use of self-expandable metallic stents in benign GI diseases. Gastrointest Endosc 58(2):207–212CrossRefPubMed

16.

Sandha GS, Marcon NE (1999) Expandable metal stents for benign esophageal obstruction. Gastrointest Endosc Clin N Am 9(3):437–446PubMed

17.

Raijman I (1999) The wallstent for benign biliary obstruction. Gastrointest Endosc Clin N Am 9(3):521–531PubMed

18.

Rayhanabad J, Abbas MA (2009) Long-term outcome of endoscopic colorectal stenting for malignant and benign disease. Am Surg 75(10):897–900PubMed

19.

Khot UP, Lang AW, Murali K, Parker MC (2002) Systematic review of the efficacy and safety of colorectal stents. Br J Surg 89(9):1096–1102CrossRefPubMed

20.

Clark JS, Buchanan GN, Khawaja AR, Rowe PH, Stoodley BJ, Saunders MP, Anderson HJ (2003) Use of the bard memotherm self-expanding metal stent in the palliation of colonic obstruction. Abdom Imaging 28(4):518–524CrossRefPubMed

21.

Binkert CA, Ledermann HP, Jost R, Zollikofer CL (1998) Metallic stenting of gastroduodenal and colonic stenoses. Abdom Imaging 23(6):580–586CrossRefPubMed

22.

Alvi A, Pitt JP (2009) A case of entero-colic fistula formation resulting from stent migration inserted for obstructing left colonic tumour. Int J Colorectal Dis 24(3):353CrossRefPubMed

23.

Song HY, Park SI, Do YS, Yoon HK, Sung KB, Sohn KH, Min YI (1997) Expandable metallic stent placement in patients with benign esophageal strictures: results of long-term follow-up. Radiology 203(1):131–136PubMed

24.

Oz MC, Forde KA (1990) Endoscopic alternatives in the management of colonic strictures. Surgery 108(3):513–519PubMed

25.

Small AJ, Young-Fadok TM, Baron TH (2008) Expandable metal stent placement for benign colorectal obstruction: outcomes for 23 cases. Surg Endosc 22(2):454–462CrossRefPubMed

Title: Treatment of benign colorectal strictures by temporary stenting with self-expanding stents
Authors: YiYang Dai
Sascha S. Chopra
Wojciech M. Wysocki
Michael Hünerbein
Publication date: 01-12-2010
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 12/2010
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-010-1038-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Treatment of benign colorectal strictures by temporary stenting with self-expanding stents

Abstract

Background

Patients and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 12/2010

The study of effect of tea polyphenols on microsatellite instability colorectal cancer and its molecular mechanism

Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer

Prognostic factors for recurrence following the initial drainage of an anorectal abscess

Expression of the xenobiotic- and reactive oxygen species-detoxifying enzymes, GST-pi, Cu/Zn-SOD, and Mn-SOD in the endocrine cells of colorectal cancer

Biosutures improve healing of experimental weak colonic anastomoses

Erratum to: Phenotypic diversity in patients with multiple serrated polyps: a genetics clinic study