Benefits of Recurrent Colonic Stent Insertion in a Patient with Advanced Gastric Cancer with Carcinomatosis Causing Colonic Obstruction

Malignant obstruction develops frequently in advanced gastric cancer. Although it is primarily the gastric outlet that is obstructed, there are occasional reports of colonic obstruction. Treating intestinal obstruction usually requires emergency surgery or stent insertion. There are several kinds of complications with stent insertion, such as bowel perforation, stent migration, bleeding, abdominal pain and reobstruction. Nevertheless, endoscopic stent insertion could be a better treatment than emergency surgery in cases of malignant bowel obstruction in cancer patients with poor performance status. We report a case of advanced gastric cancer with carcinomatosis in which a recurrent colonic stent was inserted at the same site because of cancer growth into the stent. The patient maintained a good condition for chemotherapy, thus improving their chances for survival.

[1]  G. Maddern,et al.  Self-expanding Metallic Stents for Relieving Malignant Colorectal Obstruction: A Systematic Review , 2007, Annals of surgery.

[2]  D. Kim,et al.  A dual-design expandable colorectal stent for malignant colorectal obstruction: results of a multicenter study. , 2007, Endoscopy.

[3]  J. Vandervoort,et al.  Colonic stents for malignant obstruction--not a bridge too far? , 2006, Gastrointestinal endoscopy.

[4]  R. Edwards,et al.  Colorectal stenting for colonic obstruction: the indications, complications, effectiveness and outcome--5 year review. , 2006, European journal of radiology.

[5]  M. Parker.  Colorectal stenting , 2006, The British journal of surgery.

[6]  H. Lippert,et al.  Palliative stent implantation in the treatment of malignant colorectal obstruction , 2006, Surgical Endoscopy And Other Interventional Techniques.

[7]  R. Jakobs,et al.  Self-Expanding Metal Stents Versus Plastic Prostheses in the Palliation of Malignant Dysphagia: Long-term Outcome of 153 Consecutive Patients , 2005, Journal of clinical gastroenterology.

[8]  I. Maetani,et al.  Self-expandable metallic stent placement for palliation in gastric outlet obstructions caused by gastric cancer: a comparison with surgical gastrojejunostomy , 2005, Journal of Gastroenterology.

[9]  R. Kozarek,et al.  Palliation of Gastric Outlet Obstruction and Proximal Small Bowel Obstruction With Self-expandable Metal Stents: A Single Center Series , 2005, Journal of clinical gastroenterology.

[10]  I. McCafferty,et al.  The use of self-expandable metal stents in the palliation of malignant bowel obstruction. , 2004, Oncology reports.

[11]  N. Marcon,et al.  Metal Stents for Tumors of the Distal Esophagus and Gastric Cardia , 2003, Endoscopy.

[12]  M. Parker,et al.  Systematic review of the efficacy and safety of colorectal stents , 2002, The British journal of surgery.

[13]  K. Park,et al.  Malignant obstruction of gastric outlet and duodenum: palliation with flexible covered metallic stents. , 2001, Radiology.

[14]  B. Daniele,et al.  The role of chemotherapy in the management of gastric cancer. , 2000, Journal of clinical gastroenterology.

[15]  M. Dohmoto.  New method-endoscopic implantation of rectal stent in palliative treatment of malignant stenosis , 1991 .

[16]  M. Atkinson,et al.  Fibreoptic endoscopic palliative intubation of inoperable oesophagogastric neoplasms. , 1977, British medical journal.