Gut Liver.  2013 May;7(3):311-316. 10.5009/gnl.2013.7.3.311.

Preoperative Colonoscopy for Detection of Synchronous Neoplasms after Insertion of Self-Expandable Metal Stents in Occlusive Colorectal Cancer: Comparison of Covered and Uncovered Stents

• Lim SG
• Lee KJ
• Suh KW
• Oh SY
• Kim SS
• Yoo JH
• Wi JO

• KMID: 1431348
• DOI: http://doi.org/10.5009/gnl.2013.7.3.311

Abstract

BACKGROUND/AIMS
In patients with occlusive colorectal cancers, a complete preoperative evaluation of the colon proximal to the obstruction is often impossible. We aimed to evaluate the feasibility of preoperative colonoscopy after stent placement and to determine whether the success rate of colonoscopy differs between covered and uncovered stents.
METHODS
Seventy-three patients with malignant colorectal obstruction were enrolled prospectively. In patients with a resectable cancer, a preoperative colonoscopy was performed after insertion of a self-expandable metal stent (SEMS). The success rate of complete preoperative colonoscopy was compared between covered and uncovered stents.
RESULTS
Forty-five of 73 patients who underwent stent placement had a resectable cancer (61.6%). A complete preoperative colonoscopy was possible in 40 of 45 patients (88.9%). The success rate of complete preoperative colonoscopy was significantly lower in the covered-stent group when the obstructing mass lesion was located in the sigmoid colon (p=0.024). Synchronous cancer was detected in one patient (2.2%). Stent migration was observed in four patients with a covered stent.
CONCLUSIONS
A preoperative complete colonoscopy after SEMS placement was feasible and safe in most patients with malignant colorectal obstruction. Uncovered stents seem to have more advantages than covered stents in preoperative colonoscopy proximal to the obstruction.

Keyword

Colorectal neoplasms; Stents; Colonoscopy; Neoplasms, multiple primary

MeSH Terms

Colon
Colon, Sigmoid
Colonoscopy
Colorectal Neoplasms
Humans
Neoplasms, Multiple Primary
Prospective Studies
Stents