A Pediatric Nasogastroscope Facilitates Colorectal Endoscopic Stenting

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Oncology

Background:

• Endoscopic placement of self-expandable metal stents (SEMSs) is standard for malignant colorectal obstruction.
• Complications occur in 4-20% of cases despite increasing experience.

Purpose of the Study:

• To present a modified endoscopic technique for SEMS placement.
• To evaluate the efficacy of this new technique in reducing complications and radiation exposure.

Main Methods:

• Utilized a pediatric nasogastroscope (4.8 mm diameter) for direct visualization and guidewire passage.
• Performed guidewire passage above the obstruction under direct vision.
• Employed fluoroscopy to guide guidewire advancement and stent deployment.

Main Results:

• The modified technique led to a significant reduction in both early and late complications.
• In a cohort of 64 patients, complication rates were notably decreased.
• Radiation exposure was reduced by 70% for both patients and healthcare providers.

Conclusions:

• This modified endoscopic technique offers a safer and more effective method for SEMS placement in malignant colorectal obstruction.
• The technique improves patient outcomes by minimizing procedural risks.
• Reduced radiation exposure is a key benefit for patient and operator safety.