C in palliation SEMS + surgery vs surgery Total of studies RCT 1

C in palliation SEMS + surgery vs. surgery Total of studies RCT 1 [9] 0 1 [25] 1 [29] 3 [36–38] 1 [52] 9 PNRS/OS 1 [10] 6 [5, 6, 12–14, 23] 1 [26] 3 [30–32] 0 3 [50, 53, 54] 14 CSR 1 [11] 0 0 0 0 0 1 SR 0 0 0 1 [34] 4 [43–46] 0 5 MA 0 0 0 0 0 1 [55] 1 Cost analysis 0 0 0 0 0 5 [36, 58–61] 5 [references] All the participants at PF-02341066 purchase consensus conference agree that the literature power is relatively poor and the existing RCT are often not sufficiently robust in design thus, among 6 possible treatment modalities, only 2 reached the Grade A. To help in decision making the authors wish to suggest surgeons to consider 3 further key points approaching OLCC: patient stratification according to the ACPGBI

rules; clinical environment; surgeon skill. The target as usual is to offer the best option for the patient; starting from this point of view also historical surgical option could still play a valid role. The staged procedure, with preference to the two stages, should be reserved when multimodality therapy is expected or in case of “”dramatic”" scenarios. PRA with manual decompression is a safe option and appears to be associated with best outcomes. HP might still have a role in patients at high risk for anastomotic dehiscence. TC is an appealing

option in case of synchronous polyps or click here cancer and/or impending or actual perforation of the right colon. SEMS represent a valuable option both for palliation and as a bridge to elective surgery. Obviously high clinical and technical expertise is mandatory to safely and successfully treat colonic obstruction by stents: due to this consideration routine use in practice is still limited. However we strongly support a judicious application of the procedure and encourage increased

use of stents after adequate training in referral hospitals with a goal of further testing this modality. Acknowledgements The Authors would like thank Marco Valerio Melis, MD for his help in reviewing the manuscript No financial support was required and the job has been done on a voluntary basis References 1. Phillips RK, Hittinger R, Fry JS, Fielding LP: Malignant large bowel obstruction. Br J Surg FAD 1985, 72:296–302.CrossRefPubMed 2. Mella J, Biffin A, Radcliffe AG, Stamatakis JD, {Selleck Anti-diabetic Compound Library|Selleck Antidiabetic Compound Library|Selleck Anti-diabetic Compound Library|Selleck Antidiabetic Compound Library|Selleckchem Anti-diabetic Compound Library|Selleckchem Antidiabetic Compound Library|Selleckchem Anti-diabetic Compound Library|Selleckchem Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|buy Anti-diabetic Compound Library|Anti-diabetic Compound Library ic50|Anti-diabetic Compound Library price|Anti-diabetic Compound Library cost|Anti-diabetic Compound Library solubility dmso|Anti-diabetic Compound Library purchase|Anti-diabetic Compound Library manufacturer|Anti-diabetic Compound Library research buy|Anti-diabetic Compound Library order|Anti-diabetic Compound Library mouse|Anti-diabetic Compound Library chemical structure|Anti-diabetic Compound Library mw|Anti-diabetic Compound Library molecular weight|Anti-diabetic Compound Library datasheet|Anti-diabetic Compound Library supplier|Anti-diabetic Compound Library in vitro|Anti-diabetic Compound Library cell line|Anti-diabetic Compound Library concentration|Anti-diabetic Compound Library nmr|Anti-diabetic Compound Library in vivo|Anti-diabetic Compound Library clinical trial|Anti-diabetic Compound Library cell assay|Anti-diabetic Compound Library screening|Anti-diabetic Compound Library high throughput|buy Antidiabetic Compound Library|Antidiabetic Compound Library ic50|Antidiabetic Compound Library price|Antidiabetic Compound Library cost|Antidiabetic Compound Library solubility dmso|Antidiabetic Compound Library purchase|Antidiabetic Compound Library manufacturer|Antidiabetic Compound Library research buy|Antidiabetic Compound Library order|Antidiabetic Compound Library chemical structure|Antidiabetic Compound Library datasheet|Antidiabetic Compound Library supplier|Antidiabetic Compound Library in vitro|Antidiabetic Compound Library cell line|Antidiabetic Compound Library concentration|Antidiabetic Compound Library clinical trial|Antidiabetic Compound Library cell assay|Antidiabetic Compound Library screening|Antidiabetic Compound Library high throughput|Anti-diabetic Compound high throughput screening| Steele RJC: Population-based audit of colorectal cancer management in two UK health regions. Br J Surg 1997, 84:1731–1736.CrossRefPubMed 3. Serpell JW, McDermott FT, Katrivessis H, Hughes ESR: Obstructing carcinomas of the colon. Br J Surg 1989, 76:965–969.CrossRefPubMed 4. Umpleby HC, Williamson RCN: Survival in acute obstructing colorectal carcinoma. Dis Colon Rectum 1984, 27:299–304.CrossRefPubMed 5. Tekkis PP, Kinsman R, Thompson MR, Stamatakis JD: The Association of Coloproctology of Great Britain and Ireland study of large bowel obstruction caused by colorectal cancer. Ann Surg 2004, 204:76–81.CrossRef 6.

Comments are closed.