下部直腸悪性狭窄に対する新規 proximal release 型大腸ステントの使用経験(動画付き)

Translated title of the contribution: Experience of using a novel proximal release-type colonic stent for malignant rectal obstructions(with a video)

Hirofumi Chiba, Hiroshi Nagai, Rintaro Moroi, Daisuke Okamoto, Yusuke Shimoyama, Hirohiko Shinkai, Mio Onodera, Fumitake Ishiyama, Shoichi Kayaba, Atsushi Masamune

Research output: Contribution to journalArticlepeer-review

Abstract

Self-expandable metallic stent placement is widely performed for malignant colonic obstructions. However, it is technically difficult to place a colonic stent for a rectal tumor, especially a tumor close to the dentate line, in the proper position without resulting in anal pain after stent placement. Recently, a proximal release-type (PR) stent for malignant rectal obstruction has been approved for clinical use by PMDA and covered by health insurance in Japan. This new stent is easy to place because of its structure. During placement of the PR stent, we push the delivery system of this stent during its release. The pushing movement makes it easier to place the PR stent in contrast with the conventional stent, which requires a pull-back movement. The distal edge of the PR stent is placed at the distal tumor edge to facilitate positioning of the stent close to the dentate line. We placed the PR stent in 4 patients with malignant lower rectal obstructions under palliative care. We succeeded in all four patients, and all of them had no anal pain after stent placement even though they had obstruction within 5 cm of the dentate line. Anal pain and other discomforts after stent placement can severely worsen the patients’ quality of life. Although our study included only four successful cases of PR stent placement for lower rectal obstruction, none of them had anal pain after the procedure. In bridge-to-surgery (BTS) cases, the conventional stent which requires a complicated pullback movement during its release, often becomes placed on the anal side, and it is not suitable for rectal obstruction. In contrast, the PR stent is easier to place and placement on the anal side is prevented. Therefore, a PR stent might also be suitable for rectal obstruction in BTS cases. The PR colonic stent showed good results of decompression for lower rectal obstructions close to the dentate line. Further studies are warranted to investigate the new stent’s efficacy and indications.

Translated title of the contributionExperience of using a novel proximal release-type colonic stent for malignant rectal obstructions(with a video)
Original languageJapanese
Pages (from-to)1514-1519
Number of pages6
JournalGASTROENTEROLOGICAL ENDOSCOPY
Volume63
Issue number8
DOIs
Publication statusPublished - 2021 Aug

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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