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| 1 | Surgical failure after colonic stenting as a bridge to surgery显示文摘AIM: To identify risk factors for surgical failure after colonic stenting as a bridge to surgery in left-sided malignant colonic obstruction.METHODS: The medical records of patients who underwent stent insertion for malignant colonic obstruction between February 2004 and August 2012 were retrospectively reviewed. Patients with malignant colonic obstruction had overt clinical symptoms and signs of obstruction. Malignant colonic obstruction was diagnosed by computed tomography and colonoscopy. A total of 181 patients underwent stent insertion during the study period; of these, 68 consecutive patientswere included in our study when they had undergone stent placement as a bridge to surgery in acute leftsided malignant colonic obstruction due to primary colon cancer.RESULTS: Out of 68 patients, forty-eight(70.6%) were male, and the mean age was 64.9(range, 38-89) years. The technical and clinical success rates were 97.1%(66/68) and 88.2%(60/68), respectively. Overall, 85.3%(58/68) of patients underwent primary tumor resection and primary anastomosis. Surgically successful preoperative colonic stenting was achieved in 77.9%(53/68). The mean duration, defined as the time between the SEMS attempt and surgery, was 11.3 d(range, 0-26 d). The mean hospital stay after surgery was 12.5 d(range, 6-55 d). On multivariate analysis, the use of multiple self-expanding metal stents(OR = 28.872; 95%CI: 1.939-429.956, P = 0.015) was a significant independent risk factor for surgical failure of preoperative stenting as a bridge to surgery. Morbidity and mortality rates in surgery after stent insertion were 4.4%(3/68) and 1.5%(1/68), respectively.CONCLUSION: The use of multiple self-expanding metal stents appears to be a risk factor for surgical failure. | Jung Ho Kim Kwang An Kwon Jong Joon Lee Won-Suk Lee Jeong-Heum Baek Yoon Jae Kim Jun-Won Chung Kyoung Oh Kim Dong Kyun Park Ju Hyun Kim | 2014 | World Journal of Gastroenterology2014，20，33： | 5 |
| 2 | Colorectal stenting:An advanced approach to malignant colorectal obstruction显示文摘Some colorectal cancer(CRC)patients present symptoms of bowel obstruction,which is considered a surgical emergency.Because of poor medical condition and high incidence of post-surgical complications,there has been increasing use of self-expanding metal stents(SEMS)for the purpose of palliation or as a bridge to surgery with some benefits,including shorter hospital stays,lower rates of adverse events,and one-stage surgery.However,with increasing survival of CRC patients,there have been controversial data on clinical outcomes and complications,compared between SEMS use and surgery for treatment of malignant bowel obstruction.We review recent clinical data on clinical outcomes of SEMS use compared to surgery,including complications. | Sung Pil Hong Tae Il Kim | 2014 | World Journal of Gastroenterology2014，20，43： | 4 |
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