Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2020

Jeanin E. van Hooft; Joyce V. Veld; Dirk Arnold; Regina G.H. Beets-Tan; Simon Everett; Martin Götz; Emo E. van Halsema; James Hill; Gianpiero Manes; Soren Meisner; Eduardo Rodrigues-Pinto; Charles Sabbagh; Jo Vandervoort; Pieter J. Tanis; Geoffroy Vanbiervliet; Alberto Arezzo

doi:10.1055/a-1140-3017

Endoscopy, Inhaltsverzeichnis

Endoscopy 2020; 52(05): 389-407
DOI: 10.1055/a-1140-3017

Guideline

Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2020

Authors

Jeanin E. van Hooft

¹Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, The Netherlands
Joyce V. Veld

¹Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, The Netherlands

²Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, The Netherlands
Dirk Arnold

³Department of Oncology, Hematology and Palliative Care, Asklepios Tumourzentrum Hamburg, Hamburg, Germany
Regina G.H. Beets-Tan

⁴Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Simon Everett

⁵Department of Gastroenterology and Hepatology, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom
Martin Götz

⁶Department of Gastroenterology/Oncology, Klinikum Sindelfingen-Böblingen, Kliniken Böblingen, Böblingen, Germany
Emo E. van Halsema

¹Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, The Netherlands
James Hill

⁷Department of Surgery, Manchester University NHS FT, Manchester, United Kingdom
Gianpiero Manes

⁸Department of Gastroenterology and Endoscopy, Guido Salvini Hospital, Garbagnate Milanese/Rho, Milan, Italy
Soren Meisner

⁹Endoscopy Unit, Digestive Disease Center, Bispebjerg University Hospital, Copenhagen, Denmark
Eduardo Rodrigues-Pinto

¹⁰Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
Charles Sabbagh

¹¹Department of Digestive and Oncological Surgery, University Hospital of Amiens, France
Jo Vandervoort

¹²Department of Gastroenterology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
Pieter J. Tanis

²Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, The Netherlands
Geoffroy Vanbiervliet

¹³Department of Gastroenterology, Centre Hospitalier Universitaire de l’Archet, Pôle digestif, Nice, France
Alberto Arezzo

¹⁴Department of Surgical Sciences, Università di Torino, Torino, Italy

Abstract

Main Recommendations

The following recommendations should only be applied after a thorough diagnostic evaluation including a contrast-enhanced computed tomography (CT) scan.

1 ESGE recommends colonic stenting to be reserved for patients with clinical symptoms and radiological signs of malignant large-bowel obstruction, without signs of perforation. ESGE does not recommend prophylactic stent placement.

Strong recommendation, low quality evidence.

2 ESGE recommends stenting as a bridge to surgery to be discussed, within a shared decision-making process, as a treatment option in patients with potentially curable left-sided obstructing colon cancer as an alternative to emergency resection.

Strong recommendation, high quality evidence.

3 ESGE recommends colonic stenting as the preferred treatment for palliation of malignant colonic obstruction.

Strong recommendation, high quality evidence.

4 ESGE suggests consideration of colonic stenting for malignant obstruction of the proximal colon either as a bridge to surgery or in a palliative setting.

Weak recommendation, low quality evidence.

5 ESGE suggests a time interval of approximately 2 weeks until resection when colonic stenting is performed as a bridge to elective surgery in patients with curable left-sided colon cancer.

Weak recommendation, low quality evidence.

6 ESGE recommends that colonic stenting should be performed or directly supervised by an operator who can demonstrate competence in both colonoscopy and fluoroscopic techniques and who performs colonic stenting on a regular basis.

Strong recommendation, low quality evidence.

7 ESGE suggests that a decompressing stoma as a bridge to elective surgery is a valid option if the patient is not a candidate for colonic stenting or when stenting expertise is not available.

Weak recommendation, low quality evidence.

Volltext

Referenzen

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