Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic Management
Abstract
:Simple Summary
Abstract
1. Introduction
2. Surgeon–Endoscopist Collaboration for Indication of Endoscopic Stenting
2.1. Palliative Colonic Stenting
2.2. SEMS Role as Bridge to Surgery
3. Pre-Operative Evaluation: How the Radiologist Can Help the Endoscopist
3.1. Diagnosis of Large Bowel Obstruction
3.2. Differential Diagnosis and Characteristics of Malignant Acute Colonic Obstruction from CT Scan
4. Influence of Chemotherapy on Endoscopic Colonic Stenting: The Oncologist Point of View
4.1. Timing and Safety of Chemotherapy Initiation in Patients with Acute Colonic Malignant Obstruction
4.2. Effects of Antiangiogenic Agents following Colonic Stenting
4.3. Colonic Stenting during or after Antiangiogenic Treatment
5. Endoscopic Stenting
5.1. Preparation to Endoscopy
5.2. Technique
5.3. Procedural Adverse Events and Post Endoscopic Management
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Conflicts of Interest
References
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Meta-Analyses | Short-Term Outcomes | Long-Term Outcomes | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Included Studies | Morbidity | Mortality | Stoma Rate | Permanent Stoma | VLS | LOS | OS | DFS | Local Recurrence | |
Allievi 2017, [27] | 7 RCTs (448 pts) | ES 54.8% vs. SBTS 37.8% (p = 0.02) | ns | ES 46.0% vs. SBTS 28.9% (p < 0.0001) | ES 35.2% vs. SBTS 24.5% (p < 0.02) | / | / | / | / | / |
Amelung 2018, [28] | 5 RCTs, 4 prospective, 12 retrospective (1919 pts) | / | / | / | / | / | / | 3 years and 5 years: ns | 3 years and 5 years: ns | ns |
Arezzo 2017, [29] | 8 RCTs (497 pts) | ES 51.2% vs. SBTS 33.9% (p = 0.023) | ns | ES 51.4% vs. SBTS 33.9% (p < 0.001) | ES 35.2% vs. SBTS 22.2% (p = 0.003) | / | ES 14.5 d vs. SBTS 15.5 (p = 0.039) | / | / | ES 26.6% vs. SBTS 40.5% (p = 0.09) |
Cao 2019, [30] | 5 RCTs, 3 prospective, 16 retrospective (2508 pts) | / | / | / | / | / | / | 3 years and 5 years: ns | 3 years and 5 years: ns | ns |
Ceresoli 2017, [21] | 5 RCTs, 3 prospective, 9 retrospective | / | / | / | / | / | / | ns | Ns | ns |
Foo 2019, [31] | 7 RCTs (448 pts) | Reduced in SBTS (RR 0.6, p = 0.032) | ns | / | / | / | / | 3 years: ns | 3 years: ns | ns |
Jain 2020, [32] | 8 RCTs, 25 observational (15,224 pts) | SBTS vs. ES: anastomotic leak OR 0.59 (p = 0.006), wound infection OR 0.64 (p = 0.004) | SBTS vs. ES: OR 0.69 (p = 0.010) | SBTS vs. ES: OR 0.39 (p < 0.001) | ns | SBTS vs. ES: OR 5.9 (p < 0.001) | SBTS vs. ES: Reduction in ES (<0.001) | ns | Ns | ns |
Kanaka 2022, [33] | Right-sided MLBO:#break#7 observational studies (5136 pts) | SBTS vs. ES: OR 0.78 (p = 0.003) | SBTS vs. ES: OR 0.51 (p = 0.03) | SBTS 2.0% vs. ES 11.0% (p < 0.01)) | / | SBTS 48.5% vs. ES 15.7% (p < 0.01) | / | / | / | / |
Matsuda 2015, [34] | 2 RCTs, 9 observational studies (1136 pts) | / | / | / | / | / | / | 3 y and 5 y: ns | 3 y and 5 y: ns | / |
McKechnie 2023, [35] | Network meta-analysis: 53 studies | ES vs. SBTS: OR 2.14 (p < 0.0019 | ns | / | ES vs. SBTS: OR 2.91 (p < 0.001) | / | / | 3 y and 5 y: ns | / | / |
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Mauro, A.; Scalvini, D.; Borgetto, S.; Fugazzola, P.; Mazza, S.; Perretti, I.; Gallotti, A.; Pagani, A.; Ansaloni, L.; Anderloni, A. Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic Management. Cancers 2024, 16, 821. https://doi.org/10.3390/cancers16040821
Mauro A, Scalvini D, Borgetto S, Fugazzola P, Mazza S, Perretti I, Gallotti A, Pagani A, Ansaloni L, Anderloni A. Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic Management. Cancers. 2024; 16(4):821. https://doi.org/10.3390/cancers16040821
Chicago/Turabian StyleMauro, Aurelio, Davide Scalvini, Sabrina Borgetto, Paola Fugazzola, Stefano Mazza, Ilaria Perretti, Anna Gallotti, Anna Pagani, Luca Ansaloni, and Andrea Anderloni. 2024. "Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic Management" Cancers 16, no. 4: 821. https://doi.org/10.3390/cancers16040821