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, 4 (3), 219-226

Colonic Stenting: A Practical Update

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Colonic Stenting: A Practical Update

Sanchoy Sarkar et al. Frontline Gastroenterol.

Abstract

Colonic stenting is part of the UK service provision guidelines for colorectal cancer. However, there are issues about availability and expertise within the UK, and controversies remain regarding various clinical and technical aspects of the technique. Based on the current evidence, this article will provide a practical update on the indications, the clinical and technical considerations and the remaining unanswered questions regarding colonic stenting.

Keywords: Colorectal Cancer; Colorectal Surgery; Endoprosthesis; Stents; Therapeutic Endoscopy.

Figures

Figure 1
Figure 1
Risk ratio tables for a systematic review of the four randomised control trials of self-expanding metal stents (SEMS) for a bridge to surgery versus emergency surgery. The results indicate that SEMS use is associated with higher primary anastomosis rates and lower stoma rates when compared to emergency surgery (permission from the publishers obtained).
Figure 2
Figure 2
Illustration of a colonic self-expanding metal stent (SEMS) placement using the through the scope technique courtesy of Dr Paul O'Toole. (i) Endoscopic image of the guidewire first being advanced across the obstructing colonic cancer. (ii) Endoscopic image of the SEMS delivery system passed through the biopsy channel over the guidewire and through the stricture. (iii) Radiological image of the SEMS being deployed with obvious wasting at the site of the stricture. (iv) Endoscopic image of the distal end of the SEMS successfully deployed and opened (technical success).

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