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

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  • 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
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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.

Original languageEnglish
JournalEndoscopy
Volume52
Issue number5
Pages (from-to)389-407
Number of pages19
ISSN0013-726X
DOIs
Publication statusPublished - May 2020

    Research areas

  • Colonic Neoplasms/complications, Colonoscopy, Endoscopy, Gastrointestinal, Humans, Intestinal Obstruction/etiology, Self Expandable Metallic Stents, Stents

ID: 62416990