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    
Abstract/OtherAbstract:
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.
Authors:
Ho-Young Song; Jin Hyoung Kim; Kyung Rae Kim; Ji Hoon Shin; Hee Cheol Kim; Chang-Sik Yu; Jin Cheon Kim
Related Documents :
11330584 - The altemeier repair: outpatient treatment of rectal prolapse.
12894014 - Similar outcome after colonic pouch and side-to-end anastomosis in low anterior resecti...
19226364 - Long-term failure and function after restorative proctocolectomy - a multi-centre study...
9152184 - Restorative proctocolectomy in patients older than fifty years.
1640704 - Postoperative atrial fibrillation in cancer surgery: preoperative risks and clinical ou...
19017864 - Prophylactic nasal continuous positive airway pressure following cardiac surgery protec...
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    
Affiliation:
Department of Radiology, Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Equipment Design
Female
Follow-Up Studies
Humans
Intestinal Obstruction / therapy*
Intestinal Perforation / etiology
Male
Metals
Middle Aged
Pain / etiology
Palliative Care
Polyurethanes
Rectal Diseases / therapy*
Rectal Neoplasms / complications*
Retrospective Studies
Stents* / adverse effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Metals; 0/Polyurethanes
Comments/Corrections
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


Previous Document:  Chromoendoscopy with indigo carmine dye added to acetic acid in the diagnosis of gastric neoplasia: ...
Next Document:  Nurse-administered propofol sedation compared with midazolam and meperidine for EUS: a prospective, ...