Stent placement or acute resection in colonic obstruction?

Emo E van Halsema, Pieter J Tanis, Frank ter Borg, Esther C J Consten, Willem A Bemmelman, Jeanin E van Hooft

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Abstract

When choosing a treatment for obstructing left-sided colonic carcinoma, a distinction is made between patients with increased surgical risk and patients without increased surgical risk. Patients with increased surgical risk (age > 70 years or ASA class ≥ 3) do have an indication for stent placement as a bridge to elective surgery, or as an alternative, a decompressing colostomy. Acute resection is the treatment of choice in patients without increased surgical risk, given the oncological risk associated with guidewire-related or stent-related perforation. Stent placement is recommended as the palliative treatment for patients with malignant colonic obstruction, unless the patient is simultaneously being treated with angiogenesis inhibitors (e.g. bevacizumab) as these increase the risk of stent perforation. Expertise of at least 20 colonic stent procedures is required for stent placement.

Translated title of the contributionStent placement or acute resection in colonic obstruction?
Original languageDutch
Article numberA8795
Number of pages8
JournalNederlands Tijdschrift voor Geneeskunde
Volume159
Publication statusPublished - 2015

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