Korean J Gastrointest Endosc > Volume 23(4); 2001 > Article

Korean Journal of Gastrointestinal Endoscopy 2001;23(4): 213-219.

대장 및 직장의 악성 폐쇄의 치료를 위한 경내시경적 자가확장형 니티놀 인공관 유치의 유용성 ( Usefulness of a Self - expandable Nitinol Stent Through an Endoscope for the Treatment of a Malignant Colorectal Obstruction )

이광재(Kwang Jae Lee),정성현(Seong Heon Jung),김진홍(Jin Hong Kim),함기백(Ki Baik Hahm),조성원(Sung Won Cho),서광욱(Kwang Wook Suh)

Abstract

Background/Aims:
Expandable stents were inserted for temporary decompression of the colorectum before single-stage surgery or for palliation. The aim of this study was to evaluate the usefulness of a self-expandable nitinol stent, which can be placed through the working channel of an endoscope, for treatment of malignant colorectal obstructions.
Methods:
From May 2000 to April 2001, twenty patients (eleven female, nine male, aged 39~81 years) with malignant colorectal obstructions were treated for relief from the obstructions with endoscopically guided intubation of a expandable nitino stent through the working channel of an endoscope. Of twenty patients, thirteen underwent placement of the stent for presurgical decompression; seven, for palliative decompression.
Results:
The site of obstructions were on the rectum (n=8), sigmoid colon (n=6), descending colon (n=2), transverse colon (n=3) and ascending colon (n=1). Stent placenment was successful in 18 (90%) of the 20 patients. Failure occurred in two patients with long and tortuous lesions involving hepatic flexure or splenic flexure. All patients tolerated placement of the stent well, with no procedure-related complications. Is patients with successful placement of the stent, symptoms of obstruction resolved within 72 hours. Twelve patients underwent the formal bowel preparation and elective single-stage surgery without complications 4~7 days after stent placement. In six patients, the stents provided palliative decompression of the colorectum. There was stent migration in two patients during follow-up.
Conclusions:
placement of a self-expandable nitinol stent through the working channel of an endoscope is technically feasible and safe. Stent placement allowed patients with malignant colorectal obstruction to undergo single-stage surgery in cases of operable disease and to provide palliative decompression in cases of inoperable disease. (Korean J Gastroitest Endosc 2001;23:213-219)

Key Words: 직장 및 대장의 악성 폐쇄 , 자가확장형 니티놀인공관 , 경내시경적 유치 , Malignant colorectal obstruction , Self - expandable nitinol stent , Placement through the working channel of an endoscope