INTEREST OF SELFEXPANSIVE METALLIC PROTHESIS IN THE TREATEMENT OF NEOPLASTIC COLIC OCCLUSIONS (ABOUT 27 CASES)

Aims:

The treatment of neoplastic colonic obstruction has been modified in recent years thanks to selfexpansive metallic prothesis (SEMP). It is a therapeutic alternative for emergency lifting of colonic obstruction before curative surgery and for the palliative treatment of colonic obstruction in patients who are inoperable or have unresectable tumor. The aim of this work is to evaluate the feasibility, safety and effectiveness of SEMP in the management of occlusive colorectal cancer.

Methods:

This is a retrospective, descriptive study over a period of 15 years (May 2002 to April 2017), including 27 patients admitted in hepato-gastroenterology II department of university military hospital of Rabat for neoplastic colonic obstruction and treated by placing colonic SEMP.

Results:

The mean age of the patients was 54 ± 16 years and the sex ratio M/F was 1.4. At admission, all patients had an occlusive syndrome. X-ray of the abdomen without preparation had shown fluid levels and abdominal CT had objectified a stenosing colonic process with dilatation upstream in all patients. The tumor was in the rectum in 33% of cases, left colon in 27% of cases and sigmoid in 7% of cases.

A colonic SEMP was placed in all patients under general anesthesia and the immediate clinical success was 100%. No immediate complication was noted and the average length of hospital stay was 3 days. Only one case of prosthesis migration occurred 8 months after stent placement.

Conclusions:

Colonic SEMP are an interesting alternative to surgical treatment of neoplastic colonic obstruction given the high success rate and the very low morbidity and mortality compared to surgery.