Article ; Online: Obstructing Left-Sided Colonic Cancer: Is Endoscopic Stenting a Bridge to Surgery or a Bridge to Nowhere?
Digestive diseases and sciences
2020 Volume 65, Issue 10, Page(s) 2789–2799
Abstract: For the 8-29% colorectal cancers that initially manifest with obstruction, emergency surgery (ES) was traditionally considered the only available therapy, despite high morbidity and mortality rates and the need for colostomy creation. More recently, ... ...
| Abstract | For the 8-29% colorectal cancers that initially manifest with obstruction, emergency surgery (ES) was traditionally considered the only available therapy, despite high morbidity and mortality rates and the need for colostomy creation. More recently, malignant obstruction of the left colon can be temporized by endoscopic placement of a self-expanding metallic stent (SEMS), used as bridge to surgery (BTS), facilitating a laparoscopic approach and increasing the likelihood that a primary anastomosis instead of stoma would be used. Despite these attractive outcomes, the superiority of the BTS approach is not clearly established. Few authors have stressed the potential cancer risk associated with perforations that may occur during endoscopic stent placement, facilitating neoplastic spread and negatively impacting prognosis. For this reason, the current literature focuses on long-term oncologic outcomes such as disease-free survival, overall survival and recurrence rate that do seem not to differ between the ES and BTS approaches. This lack of consensus has spawned differing and sometimes discordant guidelines worldwide. In conclusion, 20 years after the first description of a colonic stent as BTS, the debate is still open, but the growing number of articles about the use of SEMS as a BTS signifies a great interest in the topic. We hope that these data will finally converge on a single set of recommendations supporting a management strategy with well-demonstrated superiority. |
|---|---|
| MeSH term(s) | Colonoscopy/adverse effects ; Colonoscopy/instrumentation ; Colorectal Neoplasms/complications ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/therapy ; Humans ; Intestinal Obstruction/etiology ; Intestinal Obstruction/pathology ; Intestinal Obstruction/therapy ; Patient Safety ; Risk Assessment ; Risk Factors ; Self Expandable Metallic Stents ; Treatment Outcome |
| Language | English |
| Publishing date | 2020-06-25 |
| Publishing country | United States |
| Document type | Journal Article ; Review |
| ZDB-ID | 304250-9 |
| ISSN | 1573-2568 ; 0163-2116 |
| ISSN (online) | 1573-2568 |
| ISSN | 0163-2116 |
| DOI | 10.1007/s10620-020-06403-2 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
Full text online
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
| Ui V Zs.35: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.