Stent, stoma of acute resectie bij colonobstructie?

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

OnderzoeksoutputAcademicpeer review

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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.

Vertaalde titel van de bijdrageStent placement or acute resection in colonic obstruction?
Originele taal-2Dutch
ArtikelnummerA8795
Aantal pagina's8
TijdschriftNederlands Tijdschrift voor Geneeskunde
Volume159
StatusPublished - 2015

Keywords

  • Angiogenesis Inhibitors/therapeutic use
  • Bevacizumab/therapeutic use
  • Colonic Diseases/complications
  • Colonic Neoplasms/complications
  • Colostomy
  • Combined Modality Therapy
  • Elective Surgical Procedures
  • Humans
  • Intestinal Obstruction/etiology
  • Palliative Care
  • Risk Assessment
  • Stents

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