| Theme | Countermeasures of adverse events in therapeutic endoscopy | |
|---|---|---|
| Title | Adverse events due to colonic stenting and countermeasures | |
| Publish Date | 2018/02 | |
| Author | Toshio Kuwai | Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center / Endoscopy Center, National Hospital Organization Kure Medical Center and Chugoku Cancer Center |
| Author | Toshiki Yamaguchi | Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center / Endoscopy Center, National Hospital Organization Kure Medical Center and Chugoku Cancer Center |
| Author | Hiroki Imagawa | Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center / Endoscopy Center, National Hospital Organization Kure Medical Center and Chugoku Cancer Center |
| Author | Takeshi Takasago | Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center |
| Author | Tomoyuki Nishimura | Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center |
| Author | Atsushi Yamaguchi | Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center / Endoscopy Center, National Hospital Organization Kure Medical Center and Chugoku Cancer Center |
| Author | Hirotaka Kouno | Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center |
| Author | Hiroshi Kohno | Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center |
| [ Summary ] | According to reports from the Japan Colonic Stent Safe Procedure Research Group, outcomes from colonic stenting are much better in Japan than worldwide outcomes from these procedures, suggesting that colonic stenting is performed more safely in Japan. Nonetheless, colonic stenting is associated with a variety of adverse events. Some incidents can rapidly deteriorate patient's condition. Extreme caution is therefore required when performing this procedure. The first countermeasures against adverse events, should include avoiding prophylactic stenting and properly ascertaining indications for the procedure. Secondly, every endoscopist must anticipate adverse events which can occur in different cases and familiarize themselves with safe procedures. It is also important to understand the characteristics of different stents and use them appropriately. To safeguard against perforations, it is important to avoid risk factors for perforations, such as useing inappropriate types of stents and useing bevacizumab, as much as possible. As a countermeasures to avoid re-occlusion, a rapid response, for example, employing the stent-in-stent technique, must be performed. Furthermore, once an adverse event does occur, the departments of internal medicine and surgery should work together closely to provide ongoing treatment. | |