When identifying an acute MOPC, specialized gastroenterologists and colorectal surgeons selected either SEMS or diverting loop ileostomy as a BTS, considering the location and severity of the obstructing lesion, availability of SEMS, and risk of perforation. In cases of SEMS, the location and etiology of acute bowel obstruction are revealed by colonoscopy after bowel cleaning with a simple enema. The guidewire was positioned under fluoroscopy, and suitable stents were placed according to the standard method (Fig. 1 ) [16 (link)]. All the SEMSs used were uncovered (BONASTENT, Seoul, Korea; or HANAROSTENT, Seoul, Korea) and had a diameter of 24 mm and length of 60, 80, 100, or 120 mm.
Loop ileostomy was performed using a routine surgical approach [17 ]. After the abdominal wall incision at the ileostomy site, the tension-free loop of the distal ileum was pulled out of the abdominal wall to create a stoma. The sutures were then placed for mature and evert loop ileostomy. Curative resection can be performed in eligible patients after decompression of the bowel. The time of surgery was determined according to the patients’ general condition and co-morbidities and the degree of edematous bowel at the time of BTS. The surgical method was either right hemicolectomy (RHC) or extended RHC, depending on the location of the tumor. Investigation of complications and short-term outcomes associated with SEMS insertion or diverting ileostomy was performed. The result of curative resection after BTS was also analyzed for the corresponding patients to evaluate the long-term effect of the two bridge modalities.
Loop ileostomy was performed using a routine surgical approach [17 ]. After the abdominal wall incision at the ileostomy site, the tension-free loop of the distal ileum was pulled out of the abdominal wall to create a stoma. The sutures were then placed for mature and evert loop ileostomy. Curative resection can be performed in eligible patients after decompression of the bowel. The time of surgery was determined according to the patients’ general condition and co-morbidities and the degree of edematous bowel at the time of BTS. The surgical method was either right hemicolectomy (RHC) or extended RHC, depending on the location of the tumor. Investigation of complications and short-term outcomes associated with SEMS insertion or diverting ileostomy was performed. The result of curative resection after BTS was also analyzed for the corresponding patients to evaluate the long-term effect of the two bridge modalities.
