Endoscopic Clipping: A Useful Tool to Prevent Migration of Rectal Stents

 

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Self-expanding metallic stents are commonly used in the treatment of patients with obstructing colonic tumors, either for palliation or as an alternative to defunctioning ileostomy prior to radiotherapy [1]. One of the common problems encountered after stent placement is migration of the stent, which can occur in up to 14 % of patients [2] [3]. Stent migration can occur either spontaneously or as a result of the shrinkage of the tumor following radiotherapy [4].

Endoscopic clipping has been used previously to assist in the positioning of self-expanding esophageal stents [5]. We applied endoscopic clips (HX-3L, Olympus, Hamburg, Germany) at the cranial and caudal ends of a metallic stent used in the treatment of patients with obstructing left colonic tumors (Figures [1], [2]). We did not encounter any stent migration in three patients in whom this technique was applied, with uncovered Ultraflex stents being used in all patients. We feel that endoscopic clips can be used effectively to prevent migration of self-expanding metal stents.

Figure 1 Endoscopic view of the stent with the clips in situ.

Figure 2 Abdominal radiograph showing the stent with the clips in situ.

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References

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M. Buckley, M. D.

Department of Gastroenterology

Adelaide and Meath Hospital
Tallaght
Dublin
Ireland

Fax: +353-1-4143850

Email: martin.buckley@amnch.ie