If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
Herein, we describe the use of the newly developed proximal release–type colonic stent for malignant lower rectal obstruction close to the anal verge. This new stent is 22 mm in diameter, 70 mm in length, and mounted on a 16F delivery system. It has flares at both ends to prevent migration. The stent has a closed-cell design and is foreshortened by 30%. It is inserted with the over-the-wire technique (Figs. 1 and 2).
A 64-year-old man experiencing nausea and vomiting secondary to a malignant lower rectal obstruction caused by gastric cancer metastasis was referred to our center. A conventional colonic stent was technically difficult to deploy because the lesion was located 2 cm from the anal verge. To palliate this obstruction, we used the newly developed stent (Video 1, available online at www.VideoGIE.org).
We first examined the tumor using an ultraslim endoscope (Fig. 3). Gastrografin fluoroscopy revealed the stenosis length to be 4 cm (Fig. 4). The endoscope was then advanced through the stenosis to the oral side of the tumor, and a guidewire was placed across the stricture through the scope. The stent was inserted using the over-the-wire technique and released gently from the anal side while appropriate positioning was maintained under endoscopic view. The distal edge of the stent was kept at the distal tumor edge to facilitate positioning of the stent close to the anal verge. Finally, the stent was successfully deployed to the appropriate position (Fig. 5A and B). No adverse events, including pain, occurred, and oral intake was started 3 days after the procedure. The patient was discharged 8 days postprocedure.
All authors disclosed no financial relationships relevant to this publication.
The newly developed proximal release–type colonic stent was inserted using the over-the-wire technique and released gently from the anal side while appropriate positioning was maintained under endoscopic view. The distal edge of the stent was kept at the distal tumor edge to facilitate positioning of the stent close to the anal verge.
Current status of colonic stent for obstructive colorectal cancer in Japan; a review of the literature.