WallFlex colonic stent placement for management of malignant colonic obstruction: a prospective study at two centers

Alessandro Repici, Giuseppe De Caro, Carmelo Luigiano, Carlo Fabbri, Nico Pagano, Paoletta Preatoni, Silvio Danese, Lorenzo Fucci, Pierluigi Consolo, Alberto Malesci, Nicola D'Imperio, Vincenzo Cennamo

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Abstract

Background: Self-expanding metal stents (SEMSs) can alleviate malignant colonic obstruction and avoid emergency decompressive surgery. The use of colonic larger-diameter SEMSs may improve bowel function and reduce migration risk. Objective: To evaluate the effectiveness and safety of a novel large-diameter SEMS (WallFlex) designed for delivery through the endoscope in treating malignant colonic obstruction. Design: Prospective clinical cohort study. Setting: Two Italian study centers. Patients: Forty-two consecutive patients with malignant colonic obstruction: 23 requiring palliation and 19 bridging to surgery. Interventions: Colorectal SEMS placement. Main Outcome Measurements: Technical success, defined as accurate SEMS deployment across the stricture on the first attempt; clinical success, ie, complete relief of bowel obstruction without complications; and bridging to surgery, denoting the performance of elective one-stage surgery. Results: The rate of technical success was 93% (95% CI, 81%-99%) and of initial clinical success was 95% (95% CI, 84%-99%). In 58% (95% CI, 40%-84%) of the palliation group, clinical success was maintained after 6 months. All 19 patients with operable tumors were successfully bridged to one-stage elective surgery within a median of 5 days. One perforation and one stent migration occurred. All complications could be resolved nonsurgically. Limitations: No control group was included. Conclusions: In a prospective study of through-the-scope WallFlex stent placement for malignant colonic obstruction, high rates of technical and initial clinical success, and bridging to surgery were achieved. Complications could be readily managed.

Original languageEnglish
Pages (from-to)77-84
Number of pages8
JournalGastrointestinal Endoscopy
Volume67
Issue number1
DOIs
Publication statusPublished - Jan 2008

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ASJC Scopus subject areas

  • Gastroenterology

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Repici, A., De Caro, G., Luigiano, C., Fabbri, C., Pagano, N., Preatoni, P., Danese, S., Fucci, L., Consolo, P., Malesci, A., D'Imperio, N., & Cennamo, V. (2008). WallFlex colonic stent placement for management of malignant colonic obstruction: a prospective study at two centers. Gastrointestinal Endoscopy, 67(1), 77-84. https://doi.org/10.1016/j.gie.2007.08.019