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Cereatti F, Fiocca F, Dumont JL, et al. Fully covered self-expandable metal stent in the treatment of postsurgical colorectal diseases: outcome in 29 patients. Therap Adv Gastroenterol. 2016;9(2):180-8doi: 10.1177/1756283X15610052.
Cereatti, F., Fiocca, F., Dumont, J. L., Ceci, V., Vergeau, B. M., Tuszynski, T., Meduri, B., & Donatelli, G. (2016). Fully covered self-expandable metal stent in the treatment of postsurgical colorectal diseases: outcome in 29 patients. Therapeutic advances in gastroenterology, 9(2), 180-8. https://doi.org/10.1177/1756283X15610052
Cereatti, Fabrizio, et al. "Fully covered self-expandable metal stent in the treatment of postsurgical colorectal diseases: outcome in 29 patients." Therapeutic advances in gastroenterology vol. 9,2 (2016): 180-8. doi: https://doi.org/10.1177/1756283X15610052
Cereatti F, Fiocca F, Dumont JL, Ceci V, Vergeau BM, Tuszynski T, Meduri B, Donatelli G. Fully covered self-expandable metal stent in the treatment of postsurgical colorectal diseases: outcome in 29 patients. Therap Adv Gastroenterol. 2016 Mar;9(2):180-8. doi: 10.1177/1756283X15610052. PMID: 26929780; PMCID: PMC4749852.
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Therap Adv Gastroenterol. 2016 Mar;9(2):180-8. doi: 10.1177/1756283X15610052.

Fully covered self-expandable metal stent in the treatment of postsurgical colorectal diseases: outcome in 29 patients.

Therapeutic advances in gastroenterology

Fabrizio Cereatti, Fausto Fiocca, Jean-Loup Dumont, Vincenzo Ceci, Bertrand-Marie Vergeau, Thierry Tuszynski, Bruno Meduri, Gianfranco Donatelli

Affiliations

  1. Emergency Endoscopic Unit, Policlinico Umberto I, 'SAPIENZA' University of Rome, Rome, Italy.
  2. Unité d'Endoscopie Interventionnelle, RamsayGénérale de Santé, Hôpital Privé des Peupliers, Paris, France.
  3. Unité d'Endoscopie Interventionnelle, Ramsay Générale de Santé, Hôpital Privé des Peupliers, 8 Place de l'Abbé G. Hénocque, 75013 Paris, France.

PMID: 26929780 PMCID: PMC4749852 DOI: 10.1177/1756283X15610052

Abstract

BACKGROUND: Self-expandable metal stent (SEMS) placement is a minimally invasive treatment for palliation of malignant colorectal strictures and as a bridge to surgery. However, the use of SEMS for benign colorectal diseases is controversial. The purpose of this retrospective study is to evaluate the efficacy and safety of fully covered SEMS (FCSEMS) placement in postsurgical colorectal diseases.

METHODS: From 2008 to 2014, 29 patients with 32 FCSEMS deployment procedures were evaluated. The indications for stent placement were: 17 anastomotic strictures (3/17 presented complete closure of the anastomosis); four anastomotic leaks; seven strictures associated with anastomotic leak; and one rectum-vagina fistula.

RESULTS: Clinical success was achieved in 18 out of 29 patients (62.1%) being symptom-free at an average of 19 months. In the remaining 11 patients (37.9%), a different treatment was needed: four patients required multiple endoscopic dilations, 4 patients colostomy confection, one patient definitive ileostomy and three patients revisional surgery. The FCSEMS were kept in place for a mean period of 34 (range: 6-65) days. Major complications occurred in 12 out of 29 patients (41.4%) and consisted of stent migration. Minor complications included two cases of transient fever, eight cases of abdominal or rectal pain, and one case of tenesmus.

CONCLUSION: FCSEMS are considered a possible therapeutic option for treatment of postsurgical strictures and leaks. However, their efficacy in guaranteeing long-term anastomotic patency and leak closure is moderate. A major complication is migration. The use of FCSEMS for colonic postsurgical pathologies should be carefully evaluated for each patient.

Keywords: colorectum; leak; migration; postsurgical stricture; self-expandable metal stent

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