Mainar A, Tejero E, Maynar M, Ferral H, Castañeda-Zúñiga W
Department of Surgery, Hospital Central del Insalud de Soria, Spain.
Radiology. 1996 Mar;198(3):761-4. doi: 10.1148/radiology.198.3.8628867.
To evaluate the usefulness of self-expandable metallic stents in the treatment of acute colonic obstruction secondary to colorectal neoplasm.
Stents were placed in 12 patients with clinical and radiologic signs of acute colonic obstruction. After symptom improvement, patients underwent radiologic staging. Single-stage surgery was performed in patients without disseminated disease.
Stent placement was successful in all patients. Signs and symptoms of intestinal obstruction resolved within 24 hours of stent placement in 10 patients (83%). In two patients with massive bowel dilation, improvement was evident 2 and 4 days after stent placement. Ten patients underwent elective single-stage surgery with partial colonic resection and creation of a primary end-to-end anastomosis without major complications. In two patients with disseminated neoplastic disease, stent placement was considered the primary palliative treatment.
Metallic stent placement to relieve acute colonic obstruction secondary to colorectal carcinoma is a safe therapeutic alternative, allowing single-stage surgery in suitable cases. In patients who are not surgical candidates it is an adequate palliative option.
评估自膨式金属支架在治疗结直肠肿瘤继发急性结肠梗阻中的作用。
对12例有急性结肠梗阻临床及影像学表现的患者置入支架。症状改善后，患者接受影像学分期。对无播散性疾病的患者行一期手术。
所有患者支架置入均成功。10例患者（83%）在支架置入后24小时内肠梗阻的体征和症状得到缓解。2例肠管大量扩张的患者在支架置入后2天和4天症状明显改善。10例患者接受了择期一期手术，行部分结肠切除并进行一期端端吻合，无严重并发症。2例有播散性肿瘤疾病的患者，支架置入被视为主要的姑息治疗方法。
置入金属支架缓解结直肠癌继发的急性结肠梗阻是一种安全的治疗选择，在合适的病例中可实现一期手术。对于不适合手术的患者，这是一种合适的姑息治疗选择。
