| Theme |
Up-to-date Managements for Malignant Gastrointestinal Stenosis |
| Title |
Enteral Metallic Stenting as a Treatment for Obstruction of the Small Intestine or Surgically—reconstructed Intestine |
| Author |
Kazunari Nakahara |
Department of Gastroenterology and Hepatology, St.Marianna University, School of Medicine |
| Author |
Shinjiro Kobayashi |
Department of Gastroenterological and General Surgery, St.Marianna University, School of Medicine |
| Author |
Yosuke Michikawa |
Department of Gastroenterology and Hepatology, St.Marianna University, School of Medicine |
| Author |
Keigo Suetani |
Department of Gastroenterology and Hepatology, St.Marianna University, School of Medicine |
| Author |
Ryo Morita |
Department of Gastroenterology and Hepatology, St.Marianna University, School of Medicine |
| Author |
Fumio Itoh |
Department of Gastroenterology and Hepatology, St.Marianna University, School of Medicine |
| [ Summary ] |
In recent years, malignant gastrointestinal obstruction of the esophagus, stomach, duodenum, and colon has been treated with endoscopic self‒expandable metallic stent (SEMS) placement. However, in cases of malignant obstruction of the small intestine or of surgically reconstructed intestine, insertion of the endoscope into the stenotic area is difficult because of the long length and complicated bifurcation of the intestine. Recent studies have reported that a balloon endoscope (BE) is effective for the insertion of an endoscope into the distal parts of the bowel. However, SEMS placement is impossible through the working channel because the channel is too small and too long for the stent device. Therefore, we used a technique in which the BE is inserted as far as the stenotic area. After this, the BE is removed, leaving only the overtube (OT), and then the stent is placed by inserting the stent device through the OT. The technical advantage afforded by using the BE and its OT is that this procedure may allow for enteral stent placement in patients with a distal intestinal obstruction that is beyond the reach of conventional endoscopes. |