المؤلفون: Kazuna Matsutani, Yasuto Kinose, Mayuko Kato, Michiko Kodama, Kenjiro Sawada, Tadashi Kimura

المصدر: Case Reports in Women's Health, Vol 41, Iss , Pp e00589- (2024)

مصطلحات موضوعية: Pancreatic fistula, Fallopian tube cancer, Diagnostic laparoscopy, Metal colonic stent, Case report, Surgery, RD1-811, Gynecology and obstetrics, RG1-991

الوصف: Pancreatic fistulas are rare after gynecologic surgeries but are sometimes difficult to manage. A 62-year-old woman was admitted to a local hospital with acute abdominal pain. Computed tomography (CT) images showed subileus and an obstruction site in the transverse/descending colon, with invasion of peritoneal metastasis. A metal stent was placed in the bowel through colonoscopy. Suspecting advanced-stage ovarian cancer, the patient was referred to a tertiary hospital. Diagnostic laparoscopy was performed prior to neoadjuvant chemotherapy. Due to concerns raised by gastrointestinal surgeons regarding the high risk of stent perforation during chemotherapy, an abdominal colectomy of the transverse/descending colon was performed along with the removal of the disseminated tumor and the stent. Post-surgery, the patient was histologically diagnosed with stage IVB left fallopian tube carcinosarcoma. On postoperative day 3, the patient developed a fever, and CT images showed an abscess around the pancreas/spleen, prompting the placement of a drainage tube. The amylase level in the drained fluid was 258,111 U/L, leading to a diagnosis of a pancreatic fistula. Conservative management was undertaken, with drainage, fasting, and octreotide administration. After two months, the drainage tube was removed as the volume of drained fluid had decreased. After four cycles of carboplatin/paclitaxel chemotherapy, CT images showed partial response to chemotherapy, and interval debulking surgery was performed. The necessity of metallic stent placement should be carefully considered as the subileus caused by peritoneal metastasis might be alleviated by the induction of chemotherapy for gynecologic cancer.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2214911224000109Test; https://doaj.org/toc/2214-9112Test

الوصول الحر: https://doaj.org/article/2dd85b5efaa24bceb7cdf69c26ac518dTest

المؤلفون: Morgan Bressington, Alexander O’Connor, Karen Telford

المصدر: Frontiers in Gastroenterology, Vol 2 (2023)

مصطلحات موضوعية: gastroenterology, palliative care, colonic stent, malignant large bowel obstruction, survival, Diseases of the digestive system. Gastroenterology, RC799-869

الوصف: IntroductionWith palliative patients, a holistic approach is important. Interventions should minimise length of hospital stay, maximise quality of life, and control symptoms. A self-expanding metal stent (SEMS) for the palliative treatment of malignant large bowel obstruction (MLBO) is designed to provide these benefits to patients approaching the end of their life. We present the case of a patient treated with a SEMS over 2 years earlier for MLBO. He was treated with palliative intent at diagnosis because his frailty and medical co-morbidities precluded surgery. He later presented with severe tenesmus, and these new symptoms were later found to be due to a rare stent failure in which the stent had fractured and was irretrievable. This had to be managed conservatively before the patient sadly passed away 7 months later.DiscussionA SEMS is considered the first-line treatment to relieve MLBO caused by inoperable left-sided colonic cancer. This treatment offers a reduced length of hospital stay, reduced stoma rates, fewer complications, and comparable survival compared to de-functioning stoma. However, SEMSs are not expected to be in use for extended periods of time. The literature reports an average survival after a colonic stent insertion of between 121 and 199 days when used in a palliative setting.ConclusionThis is one of the first case reports to describe a colonic stent failure occurring over 2 years after insertion. This case argues that further research into the longer-term outcomes of this management option is warranted, particularly as palliative patients are living longer.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fgstr.2023.1279085/fullTest; https://doaj.org/toc/2813-1169Test

الوصول الحر: https://doaj.org/article/82b2f600b0a046f6af199f6630ab4daaTest

المؤلفون: Bressington, Morgan, O’connor, Alexander, Telford, Karen

المصدر: Bressington , M , O’connor , A & Telford , K 2023 , ' Case report and narrative review of the literature: a rare colonic stent failure in a palliative patient ' , Frontiers in Gastroenterology , vol. 2 . https://doi.org/10.3389/fgstr.2023.1279085Test

مصطلحات موضوعية: gastroenterology, palliative care, colonic stent, malignant large bowel obstruction, survival

الوصف: Introduction: With palliative patients, a holistic approach is important. Interventions should minimise length of hospital stay, maximise quality of life, and control symptoms. A self-expanding metal stent (SEMS) for the palliative treatment of malignant large bowel obstruction (MLBO) is designed to provide these benefits to patients approaching the end of their life. We present the case of a patient treated with a SEMS over 2 years earlier for MLBO. He was treated with palliative intent at diagnosis because his frailty and medical co-morbidities precluded surgery. He later presented with severe tenesmus, and these new symptoms were later found to be due to a rare stent failure in which the stent had fractured and was irretrievable. This had to be managed conservatively before the patient sadly passed away 7 months later. Discussion: A SEMS is considered the first-line treatment to relieve MLBO caused by inoperable left-sided colonic cancer. This treatment offers a reduced length of hospital stay, reduced stoma rates, fewer complications, and comparable survival compared to de-functioning stoma. However, SEMSs are not expected to be in use for extended periods of time. The literature reports an average survival after a colonic stent insertion of between 121 and 199 days when used in a palliative setting. Conclusion: This is one of the first case reports to describe a colonic stent failure occurring over 2 years after insertion. This case argues that further research into the longer-term outcomes of this management option is warranted, particularly as palliative patients are living longer.

العلاقة: https://research.manchester.ac.uk/en/publications/8c9727b4-47bd-4100-86db-29efb335a2e1Test

الإتاحة: https://doi.org/10.3389/fgstr.2023.1279085Test
https://research.manchester.ac.uk/en/publications/8c9727b4-47bd-4100-86db-29efb335a2e1Test

المؤلفون: Hiroki AOYAMA, Hiroshi MATSUMOTO, Hiroshi OKABE, Mao YAMAUCHI, Taku IIDA, Yusuke KODA, 山内 麻央, 岡部 寛, 松本 寛, 甲田 祐介, 青山 紘希, 飯田 拓

المصدر: 日本臨床外科学会雑誌 / Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association). 2023, 84(5):784

المؤلفون: Asako Fukuoka, Kohei Segami, Ryoji Makizumi, Takayuki Asano, Takehito Otsubo, Taro Hamabe

المصدر: Journal of St. Marianna University. 2023, 14(1):21

المؤلفون: Kaoru Wada, Toshio Kuwai, Syuhei Sugata, Takuro Hamada, Riho Moriuchi, Yuzuru Tamaru, Ryusaku Kusunoki, Atsushi Yamaguchi, Hirotaka Kouno, Sauid Ishaq, Hiroshi Kohno

المصدر: Journal of Clinical Medicine; Volume 11; Issue 6; Pages: 1675

مصطلحات موضوعية: SEMS, newly developed proximal release-type colonic stent, malignant colorectal obstruction, close to the anal verge

الوصف: Introduction: Colonic self-expandable metallic stents are widely used to treat malignant colorectal obstructions. Stent placement in lesions near the dentate line causes problems, including severe pain due to difficulty in positioning the stent accurately. Therefore, a proximal release-type stent was developed to overcome this issue, and this preliminary study aimed to investigate its efficacy and safety. Patients and Methods: This research enrolled eight patients with malignant colorectal obstructions up to 10 cm from the anal verge who required placement of the newly developed proximal release-type colonic stent. The primary outcome was the clinical success rate, and the secondary outcomes were the technical success and adverse events rates. Results: The technical and clinical success rates were 87.5% each, and the mean procedure time was 25.5 ± 22.0 min. The mean procedure time in the rectosigmoid colon was significantly longer than that in the rectum. Only one (12.5%) patient had stent migration, and neither anal pain nor tenesmus was observed. Discussion: The stent was highly effective in treating lesions near the anal verge, and it might contribute to the expansion of indications for colorectal stents for lesions near the dentate line. However, the indications for rectosigmoid colon lesions should be cautiously considered.

وصف الملف: application/pdf

العلاقة: Gastroenterology & Hepatopancreatobiliary Medicine; https://dx.doi.org/10.3390/jcm11061675Test

الإتاحة: https://doi.org/10.3390/jcm11061675Test

المؤلفون: Chin Tang, Yu-Nung Chen, Yi-Wei Lee, Shu-Wei Tsai

المصدر: Asian Journal of Surgery, Vol 44, Iss 12, Pp 1581-1582 (2021)

مصطلحات موضوعية: Colonic stent, Colovesical fistula, Stent migration, Colon cancer, Surgery, RD1-811

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S1015958421005285Test; https://doaj.org/toc/1015-9584Test

الوصول الحر: https://doaj.org/article/f187bba3609f45c0873369e9e4e90e9aTest

المؤلفون: Yoshihisa Saida

المصدر: Journal of the Anus, Rectum and Colon, Vol 3, Iss 3, Pp 99-105 (2019)

مصطلحات موضوعية: colonic stent, obstructive colorectal cancer, CROSS, malignant colorectal obstruction, Diseases of the digestive system. Gastroenterology, RC799-869

الوصف: Colorectal cancer is the most common cancer in Japan. Approximately 10%-20% of the patients with colorectal cancer present with large bowel obstruction, and those who present with malignant colonic obstruction (MCO) require urgent decompression because MCO can cause electrolytic fluid imbalance, colonic necrosis, bacterial translocation, and death. Placement of colonic stents (self-expandable metallic stents) for MCO is a major and standard endoscopic treatment that has been available since 2012 in Japan. This review presents the current conditions and future prospects of this procedure based on the literature. The current indication of colonic stent placement is malignant colorectal stenosis. One of the purposes of using stents is palliative treatment; further, its advantages over emergency surgery with colostomy include avoidance of colostomy, relief of obstruction, shorter hospitalization, and better quality of life. In addition, stent placement can also be used as a bridge to surgery since the duration of the hospitalization is shorter and postoperative complications, colostomy rates, and mortality rates are lower with elective than with emergency surgery. Although recent studies have reported low complication rates related to colonic stents, complications may still occur, highlighting the importance of good preparation, adequate staffing, backup systems, and informed consent. The current major problem related to colonic stents is the lack of evidence on patients' long-term prognoses for bridge to surgery purposes, awaiting the results of ongoing clinical research.

وصف الملف: electronic resource

العلاقة: https://www.jstage.jst.go.jp/article/jarc/3/3/3_2019-009/_pdf/-char/enTest; https://doaj.org/toc/2432-3853Test

الوصول الحر: https://doaj.org/article/8e6324a9ee704d21a32bd8c40939cfedTest

المؤلفون: Fumihiko Ando, Akihisa Matsuda, Masao Miyashita, Satoshi Matsumoto, Nobuyuki Sakurazawa, Youichi Kawano, Hiroshi Yoshida

المصدر: Surgical Case Reports, Vol 4, Iss 1, Pp 1-6 (2018)

مصطلحات موضوعية: Obstructive colorectal cancer, Self-expandable metallic colonic stent, Bridge to surgery, Neoadjuvant therapy, Surgery, RD1-811

الوصف: Abstract Background Self-expandable metallic stent placement is a widely performed palliative procedure or bridge to surgery for obstructive colorectal cancer. However, the feasibility of this procedure for large bowel obstruction induced by effective neoadjuvant therapy is unclear. Case presentation We herein report three such cases involving a 61-year-old man who underwent neoadjuvant chemoradiotherapy for lower rectal cancer, a 56-year-old woman who underwent neoadjuvant chemotherapy for lower rectal cancer, and a 63-year-old woman who underwent neoadjuvant chemotherapy for lower rectal cancer. All were emergently hospitalized with large bowel obstruction that developed while undergoing neoadjuvant therapy. Colonoscopy revealed smooth strictures caused by effective neoadjuvant therapy. Self-expandable metallic stents were placed across the obstruction as a bridge to surgery, and laparoscopic low anterior resection was uneventfully performed in all patients. Conclusions We successfully treated three patients with large bowel obstruction induced by a good response to neoadjuvant therapy using self-expandable metallic stents as a bridge to surgery. Further studies with larger sample sizes are warranted to assess the feasibility of this strategy.

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s40792-018-0509-1Test; https://doaj.org/toc/2198-7793Test

الوصول الحر: https://doaj.org/article/4e3290541a274aea989c85916f8fd8e2Test

المؤلفون: Morino, Mario, Arezzo, Alberto, Farnesi, Francesca, Forcignanò, Edoardo

المساهمون: Morino, Mario, Arezzo, Alberto, Farnesi, Francesca, Forcignanò, Edoardo

مصطلحات موضوعية: colonic stent, colonic obstruction, colorectal cancer

الوصف: Nowadays, colorectal cancer (CRC) is the third most frequent cancer, and about a third of patients with CRC presents themselves with symptoms of large bowel obstruction. Historically, surgical resection was the treatment of choice for colonic obstruction, but this kind of approach is burdened by a high risk of postoperative morbidity and mortality. In recent times, the use of a colonic stent has been proposed to overcome the obstruction and transform an emergency surgical case into an elective one to avoid emergency surgery complications. Endoscopic stenting is the first-line treatment option in the palliative management of colonic obstruction, and there is sufficient scientific evidence to support this approach. However, endoscopic stent used as a bridge to surgery is not yet widely adopted because the concern was raised about the long-term survival and cancer safety of this approach. The recent scientific evidence has shown that this approach improves the short-term outcomes, such as postoperative complications and the stoma rate, without differences in long-term outcomes compared to emergency surgery. Therefore, the European Society for Gastrointestinal Endoscopy in 2020 has reconsidered stenting as a bridge to surgery as a valid alternative to emergency surgery

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/33915760; info:eu-repo/semantics/altIdentifier/wos/WOS:000643205900001; volume:57; issue:4; firstpage:1; lastpage:9; numberofpages:9; journal:MEDICINA; http://hdl.handle.net/2318/1783877Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85104544688

الإتاحة: http://hdl.handle.net/2318/1783877Test