Document Detail

Malignant rectal obstruction within 5 cm of the anal verge: is there a role for expandable metallic stent placement?
MedLine Citation:
PMID:  18561924     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Placement of expandable metallic stents (EMS) has been considered contraindicated for patients with malignant rectal obstruction within 5 cm of the anal verge because of the potential problems of anal pain. OBJECTIVE: Our purpose was to investigate the technical feasibility, clinical effectiveness, and safety of EMS placement in patients with malignant rectal obstruction within 5 cm of the anal verge. DESIGN: Retrospective study. SETTING: Single tertiary referral university hospital. PATIENTS: The sites of obstruction included the rectum within 5 cm (range, 25-50 mm) of the anal verge in 16 patients (group A) and more than 5 cm (range, 53-74 mm) in 14 patients (group B). INTERVENTIONS: Placement of 3 types of EMS. MAIN OUTCOME MEASUREMENTS: Complications including pain were evaluated and compared between 2 groups with the Fisher exact test. RESULTS: The overall technical success rate was 100%. Colon perforation occurred in 2 patients, who underwent emergency surgery. Ten (62.5%) of group A and 1 (7.1%) of group B complained of pain (P = .011). In 3 of the 10 patients in group A, the pain disappeared spontaneously within a week or was tolerated by the patients without use of analgesics, although the remaining 7 patients of group A and the 1 patient in group B needed analgesics until death or elective surgery. LIMITATIONS: Retrospective study. CONCLUSIONS: Placement of EMS in patients with malignant rectal obstruction within 5 cm of the anal verge seems feasible and relatively safe and may provide adequate palliation and preoperative decompression of obstruction symptoms. Anal pain was tolerable to the patients with or without use of analgesics.
Ho-Young Song; Jin Hyoung Kim; Kyung Rae Kim; Ji Hoon Shin; Hee Cheol Kim; Chang-Sik Yu; Jin Cheon Kim
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-06-17
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  68     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-17     Completed Date:  2009-02-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  713-20     Citation Subset:  IM    
Department of Radiology, Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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MeSH Terms
Aged, 80 and over
Equipment Design
Follow-Up Studies
Intestinal Obstruction / therapy*
Intestinal Perforation / etiology
Middle Aged
Pain / etiology
Palliative Care
Rectal Diseases / therapy*
Rectal Neoplasms / complications*
Retrospective Studies
Stents* / adverse effects
Treatment Outcome
Reg. No./Substance:
0/Metals; 0/Polyurethanes
Comment In:
Gastrointest Endosc. 2008 Oct;68(4):721-3   [PMID:  18926180 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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