Surgery after colonic stenting Journal Article

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Authors: Gross, K. N.; Francescatti, A. B.; Brand, M. I.; Saclarides, T. J.
Article Title: Surgery after colonic stenting
Abstract: Colonic stenting is an accepted treatment of large bowel obstruction. The literature is sparse regarding surgical difficulties associated with an indwelling stent. We report our experience focusing on outcomes, complications, and whether the stent created intraoperative concerns. In this retrospective review, 6 patients were identified between 2007 and 2010 that had surgery after colonic stents were placed. Their charts were reviewed to compare clinical variables, surgical procedures, outcomes, and complications. One obstruction was due to diverticulitis. The stent reobstructed, leading to emergent transverse loop colostomy, and subsequent sigmoidectomy with stoma reversal. Four patients' obstructing masses were malignant. The final patient's stent was placed through a Hartmann's stump to drain a pelvic abscess. These 5 patients had no stent complications. Surgery occurred an average of 9.8 weeks after stent placement; four had low anterior resections and one underwent Hartmann's reversal. All 6 patients had colorectal anastomoses and five underwent laparoscopic surgery; one had an anastomotic leak requiring reoperation. Colonic stenting allows for the immediate relief of obstruction while permitting diagnosis and treatment of coexisting medical problems. The colon can be prepared for an elective rather than emergency operation, and a colostomy may be avoided.
Journal Title: The American Surgeon
Volume: 78
Issue: 6
ISSN: 1555-9823; 0003-1348
Publisher: Unknown  
Journal Place: United States
Date Published: 2012
Start Page: 722
End Page: 727
Language: eng
Notes: JID: 0370522; ppublish