PREOPERATIVE ENDOSCOPIC EVALUATION AFTER INSERTING A SELF-EXPANDING COLORECTAL STENT AS A BRIDGE TO SURGERY

Abstract

Due to distal stenosis, preoperative evaluation of the entire colon in patients with obstructive colorectal cancer is not possible. However, the prevalence of synchronous multiple cancers is relatively high in patients with obstructive colorectal cancer, and thus accurate preoperative evaluation of the proximal colon is very important. Since 2012, the use of a self-expanding colorectal stent as a bridge to surgery (BTS) has become widespread in Japan. Five patients with obstructive colorectal cancer who successfully underwent total colonoscopy through the stent using a small-caliber colonoscopy are reported. Three of the five patients were found to have another cancer (one advanced and two early cancers) in the proximal colon, and simultaneous resection was performed in the two cases with early cancers. Preoperative endoscopic evaluation after inserting a self-expanding colorectal stent is clinically very useful both to diagnose multiple synchronous lesions and to determine the safety margin for resection.