Faculty Collaboration Database

Sigmoid stiffener for decompression tube placement in colonic pseudo-obstruction. Endoscopy 2000 Jan;32(1):54-7

Date

02/26/2000

Pubmed ID

10691273

DOI

10.1055/s-2000-85

Scopus ID

2-s2.0-0033959354 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

BACKGROUND AND STUDY AIMS: Decompression tube placement improves outcome in colonic pseudo-obstruction (CP) which is refractory to conservative measures, especially if the decompression tube is placed proximal to the hepatic flexure. We evaluate the ability of a sigmoid stiffener to facilitate more proximal colonoscopy and decompression tube placement.

PATIENTS AND METHODS: A sigmoid stiffener is used in the standard fashion during colonoscopic decompression for pseudo-obstruction. After cecal wire placement, the colonoscope is withdrawn, leaving the stiffener and wire in place. By passing through the stiffener, an over-wire decompression tube can avoid sigmoid looping. We compared proximal extent of colonoscopy, tube position, endoscopy time, and patient outcomes using a sigmoid stiffener, with a control group of patients treated previously. Patients with colonic ischemia were excluded.

RESULTS: Using this technique, nine consecutive colonoscopies and decompression tube placements reached the right colon. Significantly, only three of seven control colonoscopies and two control decompression tubes did so. However, improvements in procedural time and patient outcome did not reach statistical significance. No complications occurred.

CONCLUSION: The use of a sigmoid stiffener during colonic decompression allows more proximal colonoscopy and decompression tube placement, with possible clinical benefit. We do not use this technique in the setting of left colon ischemia.

Author List

Berger WL, Saeian K

Authors

William L. Berger MD Associate Professor in the Medicine department at Medical College of Wisconsin
Kia Saeian MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Colonic Pseudo-Obstruction
Decompression, Surgical
Equipment Design
Female
Humans
Male
Middle Aged
Prostheses and Implants
Sigmoidoscopes