Colonic Stenting
What is Colonic stenting ?
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Why do you need Colonic stenting ?
Colonic stenting is indicated for:
- Colorectal cancer: Malignant obstructions in the colon or rectum, often in advanced stages, to relieve symptoms like pain, bloating, or constipation.
- Palliative care: For patients with inoperable tumors or poor surgical candidacy due to comorbidities or metastasis.
- Bridge to surgery: Temporary relief of obstruction to stabilize patients before elective surgery, avoiding emergency procedures.
- Benign conditions (rare): Strictures from inflammatory bowel disease (IBD), diverticulitis, or post-surgical scarring.
- External compression: Obstruction from pelvic tumors or metastases.
The procedure aims to restore bowel patency, prevent complications like perforation, and improve symptoms without immediate surgery. In India, hospitals like Apollo, Fortis, Medanta, Tata Memorial, and AIIMS specialize in colonic stenting, using advanced endoscopic and fluoroscopic techniques.
Why Do Costs Vary in Philippines?
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Colonic stenting Procedure
The procedure is minimally invasive, performed by an interventional gastroenterologist or radiologist:
- Before Procedure Evaluation:
- Diagnosis is confirmed via colonoscopy or sigmoidoscopy with biopsy to identify the obstruction’s cause (e.g., cancer).
- Imaging (CT scan, contrast enema) assesses the obstruction’s location, length, and degree, ensuring stenting is feasible.
- Blood tests evaluate infection, anemia, or organ function for procedural safety.
- Bowel preparation (enemas or laxatives) may be limited due to obstruction, but IV antibiotics are given to reduce infection risk.
- Patients are counseled on stent function, dietary adjustments, and potential complications.
- Procedure:
- Performed under moderate sedation (e.g., midazolam, fentanyl) or general anesthesia, lasting 30–60 minutes.
- The patient is positioned on their side or back in an endoscopy or fluoroscopy suite.
- A colonoscope or flexible sigmoidoscope is inserted through the rectum to visualize the obstruction.
- Under fluoroscopic guidance (X-ray imaging), a guidewire is passed through the obstruction, followed by the deployment of a self-expanding metal stent (SEMS).
- The stent expands to open the blocked segment, restoring bowel patency.
- Post-procedure imaging (X-ray or CT) confirms stent placement and patency.
- The procedure is typically outpatient or requires a 1–2 day hospital stay for observation.
- After Procedure:
- Patients are monitored for 4–24 hours to ensure stent function, pain control, and no immediate complications (e.g., perforation).
- Bowel movements typically resume within 24–48 hours, relieving obstructive symptoms.
- A low-residue diet is advised initially, transitioning to a regular diet as tolerated.
- Palliative patients receive oncology referrals for chemotherapy or radiation; surgical candidates are planned for elective resection.
Recovery After Colonic stenting
Recovery is rapid due to the minimally invasive nature of the procedure:
- Hospital Stay:
- Most patients are discharged within 24 hours (outpatient) or 1–2 days if observation is needed.
- Palliative or unstable patients may require longer stays (3–5 days) for symptom management.
- Post-Procedure Care:
- Mild pain or discomfort is managed with oral painkillers (e.g., paracetamol).
- Patients are monitored for stent patency (bowel movements) and complications (e.g., bleeding, perforation).
- Antibiotics may be prescribed short-term to prevent infection.
- Dietary advice includes low-residue foods (e.g., white rice, bananas) for 1–2 weeks, avoiding high-fiber or gas-producing foods (e.g., beans, broccoli).
- Activity and Diet:
- Light activities (e.g., walking) resume within 1–2 days; strenuous activities are avoided for 1–2 weeks.
- Normal activities (work, driving) resume within 3–7 days, depending on overall health.
- Adequate hydration and gradual reintroduction of fiber prevent constipation or stent blockage.
- Follow-Up:
- Follow-up visits at 1–2 weeks assess symptom relief and stent function via physical exam or imaging (X-ray, CT).
- Palliative patients continue oncology care (e.g., chemotherapy); surgical candidates undergo elective colectomy within 1–3 months.
- Long-term monitoring for cancer patients includes CEA levels and imaging every 3–6 months.
Most patients experience symptom relief within 24–48 hours, with 80–90% technical success rates for stent placement. Palliative stenting improves quality of life, while bridging to surgery reduces emergency surgery risks. Median stent patency is 6–12 months, though re-intervention may be needed for complications.
Risks and Complications
Colonic stenting is generally safe but carries risks:
- Procedure-Related Risks:
- Perforation (1–5%), potentially requiring emergency surgery.
- Bleeding at the stent site, usually minor but rarely requiring transfusion.
- Stent-Related Complications:
- Stent migration (5–10%), where the stent shifts, necessitating repositioning or replacement.
- Stent obstruction (10–20%) due to tumor ingrowth, food impaction, or stool, requiring re-stenting or surgery.
- Pain or tenesmus (rectal discomfort), particularly with rectal stents.
- General Risks:
- Adverse reactions to sedation or contrast dye.
- Infection (e.g., abscess), requiring antibiotics or drainage.
- Long-Term Issues:
- Tumor progression in palliative cases, reducing stent effectiveness.
- Rarely, fistula formation or erosion into adjacent structures.
Prompt reporting of symptoms like severe pain, fever, no bowel movements, or rectal bleeding ensures timely management.
Frequently Asked Questions (FAQs)
What causes the need for colonic stenting?
The primary cause is colorectal cancer causing obstruction; less common causes include benign strictures, IBD, or external tumor compression.
Is colonic stenting a permanent solution?
In palliative cases, it’s long-term but not permanent (6–12 months patency). As a bridge to surgery, it’s temporary until elective resection.
Can stenting be done instead of surgery?
Stenting avoids immediate surgery in palliative cases or as a bridge but isn’t a substitute for curative resection in operable cancers.
How soon can I resume normal activities?
Most patients resume normal activities within 3–7 days, with light activities starting in 1–2 days.
Is colonic stenting covered by insurance in India?
Most insurance plans cover stenting for malignant obstructions or emergencies. Confirm with your provider.
What are the signs of complications post-stenting?
Severe pain, fever, no bowel movements, or rectal bleeding require immediate medical attention.
Can elderly patients undergo colonic stenting?
Yes, stenting is particularly suitable for elderly or frail patients with inoperable tumors or high surgical risks.
What lifestyle changes are needed post-stenting?
Follow a low-residue diet initially, stay hydrated, avoid constipation, and attend oncology follow-ups for cancer patients.
Conclusion
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Looking for Best Hospitals for Colonic stenting
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.