Feng Yadong, Yu Qian, Li Ming, Xu Wei, Zhu Ye, Liu Yang, Shi Ruihua
Department of Gastroenterology, Zhongda Hospital, School of Medicine, Southeast University, 87 Dingjiaqiao Road, Nanjing, China 210009.
Gastroenterol Res Pract. 2020 Jan 10;2020:6810164. doi: 10.1155/2020/6810164. eCollection 2020.
Endoscopic self-expandable metallic stent (SEMS) insertion for acute colonic obstruction caused by colorectal cancer (CRC) is always performed under fluoroscopic guidance. This study evaluated the feasibility and safety of an endoscopic stenting procedure without fluoroscopic guidance.
A total of 36 patients with an acute colonic obstruction caused by CRC underwent endoscopic SEMS insertion using a colonoscope without fluoroscopic guidance, followed by analyses of the technical and clinical success and short-term complications.
Total technical success rate and clinical success rate were 91.7% and 86.1%, respectively. The mean procedure time was 21.2 ± 10.3 minutes. There was no stent dislodgement. One case of hematochezia and two cases of tenesmus occurred in patients with left-sided complete obstructions. No other short-term complications occurred. Procedure time, technical success, and clinical success rate were 16.3 ± 9.4 minutes, 93.1%, and 89.6% for left-sided obstructions, respectively, and were 26.8 ± 10.7 minutes, 85.7%, and 71.4% for right-sided obstructions, respectively. For complete obstructions, procedure time, technical success, and clinical success rate were 22.5 ± 8.9 minutes, 90%, and 83.3%, respectively. In the incomplete cases, procedure time, technical success, and clinical success were 13.5 ± 6.7 minutes, 100%, and 100%, respectively. Technical success, clinical success, and short-term complications were not differed between lesion locations and degrees.
This simple technique is feasible and safe for palliation of acute colonic obstruction caused by CRC.
结直肠癌（CRC）所致急性结肠梗阻的内镜下自膨式金属支架（SEMS）置入术通常在荧光透视引导下进行。本研究评估了无荧光透视引导下内镜支架置入术的可行性和安全性。
共有36例由CRC引起的急性结肠梗阻患者在无荧光透视引导下使用结肠镜进行内镜SEMS置入，随后分析技术成功率、临床成功率和短期并发症。
总技术成功率和临床成功率分别为91.7%和86.1%。平均手术时间为21.2±10.3分钟。无支架移位情况。左侧完全梗阻患者中发生1例便血和2例里急后重。未发生其他短期并发症。左侧梗阻的手术时间、技术成功率和临床成功率分别为16.3±9.4分钟、93.1%和89.6%，右侧梗阻分别为26.8±10.7分钟、85.7%和71.4%。对于完全梗阻，手术时间、技术成功率和临床成功率分别为22.5±8.9分钟、90%和83.3%。在不完全梗阻病例中，手术时间、技术成功率和临床成功率分别为13.5±6.7分钟、100%和100%。技术成功率、临床成功率和短期并发症在病变部位和程度之间无差异。
这种简单技术对于缓解CRC所致急性结肠梗阻是可行且安全的。
