Erschienen in:
24.04.2019 | Colorectal Cancer
Bridging the Gap: Making Sense of the Diverging Evidence for Self-Expandable Metallic Stents in Malignant Colonic Obstructions
verfasst von:
Georgios Karagkounis, MD, David Liska, MD, FACS, FASCRS
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 9/2019
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Excerpt
Acute colonic obstruction secondary to nonmetastatic colon cancer is a challenging clinical scenario that, unfortunately, remains common despite recent advances in population-wide screening. Even though often still considered a surgical emergency, the advent of advanced endoscopic techniques and the development of ever more effective self-expandable metal stents (SEMS) offer an attractive alternative to emergency surgery (ES). When successfully deployed, SEMS enable colonic decompression and symptom palliation until a definitive surgical intervention can be accomplished in a planned and elective manner, a pathway termed “bridge-to-surgery” (BTS). Because both ES and SEMS as BTS have distinct advantages and disadvantages, the goal of developing an evidence-based approach to select the most appropriate strategy for each individual patient remains elusive. With up to 20% of patients with colonic adenocarcinoma presenting with partial or complete obstruction, the need for high-quality data to drive clinical practice is more urgent than ever. …
