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

• Published in: Gut and liver Vol. 7; no. 3; pp. 311 - 316
• Main Authors: Sun Gyo Lim, Kwang Jae Lee, Kwang Wook Suh, Seung Yeop Oh, Soon Sun Kim, Jun Hwan Yoo, Jeong Ook Wi
• Format: Journal Article
• Language: Korean
• Published: 대한소화기내시경학회 30.05.2013
• Subjects: Colonoscopy; Colorectal neoplasms; multiple primary; Neo-plasms; Stents
• ISSN: 1976-2283; 2005-1212

Background/Aims: In patients with occlusive colorectal can-cers, a complete preoperative evaluation of the colon proxi-mal to the obstruction is often impossible. We aimed to eval-uate 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 re-sectable 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 sig-nificantly lower in the covered-stent group when the obstruct-ing 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 af-ter SEMS placement was feasible and safe in most patients with malignant colorectal obstruction. Uncovered stents seem to have more advantages than covered stents in pre-operative colonoscopy proximal to the obstruction.