Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic Management
Patients presenting with acute colonic obstruction are usually evaluated in the emergency department and multiple specialties are involved in the patients’ management. Pre-treatment evaluation is essential in order to establish the correct endoscopic indication for stent implantation. Contrast-enhan...
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/4/821 |
| _version_ | 1797298600355561472 |
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| author | Aurelio Mauro Davide Scalvini Sabrina Borgetto Paola Fugazzola Stefano Mazza Ilaria Perretti Anna Gallotti Anna Pagani Luca Ansaloni Andrea Anderloni |
| author_facet | Aurelio Mauro Davide Scalvini Sabrina Borgetto Paola Fugazzola Stefano Mazza Ilaria Perretti Anna Gallotti Anna Pagani Luca Ansaloni Andrea Anderloni |
| author_sort | Aurelio Mauro |
| collection | DOAJ |
| description | Patients presenting with acute colonic obstruction are usually evaluated in the emergency department and multiple specialties are involved in the patients’ management. Pre-treatment evaluation is essential in order to establish the correct endoscopic indication for stent implantation. Contrast-enhanced imaging could allow the exclusion of benign causes of colonic obstruction and evaluation of the length of malignant stricture. Endoscopic stenting is the gold standard of treatment for palliative indications whereas there are still concerns about its use as a bridge to surgery. Different meta-analyses showed that stenting as a bridge to surgery improves short-term surgical outcomes but has no role in improving long-term outcomes. Multidisciplinary evaluation is also essential in patients that may be started on or are currently receiving antiangiogenic agents because endoscopic stenting may increase the risk of perforation. Evidence in the literature is weak and based on retrospective data. Here we report on how to correctly evaluate a patient with acute colonic malignant obstruction in collaboration with other essential specialists including a radiologist, surgeon and oncologist, and how to optimize the technique of endoscopic stenting. |
| first_indexed | 2024-03-07T22:38:22Z |
| format | Article |
| id | doaj.art-14be2186787e448591ca4568a5605d10 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-07T22:38:22Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-14be2186787e448591ca4568a5605d102024-02-23T15:11:21ZengMDPI AGCancers2072-66942024-02-0116482110.3390/cancers16040821Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic ManagementAurelio Mauro0Davide Scalvini1Sabrina Borgetto2Paola Fugazzola3Stefano Mazza4Ilaria Perretti5Anna Gallotti6Anna Pagani7Luca Ansaloni8Andrea Anderloni9Gastroenterology and Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, ItalyGastroenterology and Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, ItalyMedical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyDepartment of General Surgery, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyGastroenterology and Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, ItalyInstitute of Radiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyInstitute of Radiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyMedical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyDepartment of General Surgery, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyGastroenterology and Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, ItalyPatients presenting with acute colonic obstruction are usually evaluated in the emergency department and multiple specialties are involved in the patients’ management. Pre-treatment evaluation is essential in order to establish the correct endoscopic indication for stent implantation. Contrast-enhanced imaging could allow the exclusion of benign causes of colonic obstruction and evaluation of the length of malignant stricture. Endoscopic stenting is the gold standard of treatment for palliative indications whereas there are still concerns about its use as a bridge to surgery. Different meta-analyses showed that stenting as a bridge to surgery improves short-term surgical outcomes but has no role in improving long-term outcomes. Multidisciplinary evaluation is also essential in patients that may be started on or are currently receiving antiangiogenic agents because endoscopic stenting may increase the risk of perforation. Evidence in the literature is weak and based on retrospective data. Here we report on how to correctly evaluate a patient with acute colonic malignant obstruction in collaboration with other essential specialists including a radiologist, surgeon and oncologist, and how to optimize the technique of endoscopic stenting.https://www.mdpi.com/2072-6694/16/4/821acute colonic obstructioncolorectal cancerendoscopic stentbridge to surgeryantiangiogenic agentsself-expandable metal stent |
| spellingShingle | Aurelio Mauro Davide Scalvini Sabrina Borgetto Paola Fugazzola Stefano Mazza Ilaria Perretti Anna Gallotti Anna Pagani Luca Ansaloni Andrea Anderloni Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic Management Cancers acute colonic obstruction colorectal cancer endoscopic stent bridge to surgery antiangiogenic agents self-expandable metal stent |
| title | Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic Management |
| title_full | Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic Management |
| title_fullStr | Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic Management |
| title_full_unstemmed | Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic Management |
| title_short | Malignant Acute Colonic Obstruction: Multidisciplinary Approach for Endoscopic Management |
| title_sort | malignant acute colonic obstruction multidisciplinary approach for endoscopic management |
| topic | acute colonic obstruction colorectal cancer endoscopic stent bridge to surgery antiangiogenic agents self-expandable metal stent |
| url | https://www.mdpi.com/2072-6694/16/4/821 |
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