Περίληψη:
Given the increasing prevalence and incidence of colorectal cancer, more patients will suffer from colonic obstruction and therefore need appropriate treatment. Currently, patients can undergo either emergency surgery (ES), which encompasses colostomy, or endoscopic self-expandable metal stent (SEMS) placement. However, ES carries a substantial risk of morbidity and mortality; therefore, attention has been increasingly drawn on the endoscopic placement of SEMS. SEMS can be inserted under endoscopic and/or fluoroscopic view. Main adverse events encompass stent failure, perforation, migration, and re-obstruction. As a bridge to surgery, SEMS placement is controversial due to concern on long-term oncological outcomes. However, recent studies have shown a similar survival rate as compared to surgery, when stenting is carried out in highly experienced centers. In the palliative setting, SEMS placement is contraindicated in patients treated or planned to be treated with bevacizumab or other antiangiogenic drugs. Nevertheless, we will discuss the existing evidence showing conflicting results. In summary, this review will focus on the technique of SEMS insertion, indications, outcomes, and adverse events, both as a bridge-to-surgery strategy and in the palliative setting, disserting the most recent evidence. © 2020 Elsevier Inc.
Συγγραφείς:
Frazzoni, L.
Fabbri, E.
Bazzoli, F.
Triantafyllou, K.
Fuccio, L.
