Novosti
Khirurgii

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Year 2016 Vol. 24 No 5

REVIEWS

A.I. CHERNOOKOV1, M.M. KARAPETYAN2, V.V. BAGDASAROV1, H.A. BAGDASAROVA1, M.V. KOSACHENCO2, A.P. MOISEEV1

COLORECTAL STENTING IN TREATMENT OF MALIGNANT LARGE BOWEL OBSTRUCTION

SBEE HPE "I.M. Sechenov First Moscow State Medical University"1,
SBME "City Clinical Hospital named after S.S.Judin of Moscow Health Care Department"2.
Moscow.
The Russian Federation

Review the recent literature data for colonic stenting application in patients with malignant large bowel obstruction has been analyzed. Colorectal stent application is considered to be a real alternative for the emergency surgery. First of all stent is performed for temporary colonic decompression as a bridge to the surgery followed by a delayed radical operation in resectable cases. The second indication – stents are being increasingly used to solve malignant large bowel obstruction (unresectable and / or metastatic cancer). The placement of colorectal stents has been carried out with endoscopic guidance, fluoroscopy guidance, or a combined technique. The average clinical effectiveness of stenting is 80-90%. The effectiveness of stenting is affected by the extent of tumor stricture, patient’s status, and experience of endoscopist, cancer localization and the source of tumor. In the case of a complete obstruction the outcomes of stenting are worse compared with a subtotal obstruction. “A bridge to the surgery” approach improves immediate outcomes of management in patients with malignant large bowel obstruction compared with emergency surgical interventions. The optimal time until elective radical surgery is 5-10 days after stent insertion. The long-term oncologic outcomes of a bridge method are insufficiently studied. The stent insertion may affect negatively on 5-year overall survival and cancer recurrence rate. In patients with unresectable and/or metastatic cancer, complicated by malignant large bowel obstruction, the stenting improves the quality of life, reduces the hospitalization time. The complications of colorectal stenting include stent-induced colonic perforation, colonic re-obstruction, stents migration, inadequate colonic decompression, pain, bleeding. Further individualisation of treatment tactics of malignant large bowel obstruction should be carefully considered the advantages and disadvantages of colonic stenting.

Keywords: colorectal cancer, colorectal stenting, colonic perforation, malignant large bowel obstruction, self-expandable metallic stents, hospitalization time, quality of life
p. 497-507 of the original issue
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Address for correspondence:
119991, Russian Federation, Moscow, Trubetskaya st., 8/2.
First Moscow State Medical University named after IM Sechenov,
department N2 of hospital surgery.
Tel:. +7-985-167-43-66
E-mail: sanpali4@yandex.ru
Moiseev Aleksandr Pavlovich
Information about the authors:
Chernookov A.I. MD, Professor, Head of department N2 of hospital surgery, SBEE HPE "I.M.Sechenov First State Medical University".
Karapetyan M.M. PHD, Head of surgical department, SBME "City Clinical Hospital named after S.S.Judin".
Bagdasarov V.V. MD, Professor of department ¹ 2 of hospital surgery, SBEE HPE "I.M.Sechenov First State Medical University".
Bagdasarova E.A. MD, Professor of department N 2 of hospital surgery, SBEE HPE "I.M.Sechenov First State Medical University".
Kosachenco M.V. Surgeon of Moscow Health Care department., SBME "City Clinical Hospital named after S.S.Judin".
Moiseev A.P. Post-graduate student of department N2 of hospital surgery, SBEE HPE "I.M.Sechenov First State Medical University",
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