342 Copyright © 2017 Society of Gastroenterology Nurses and Associates Gastroenterology Nursing
C
olorectal cancer is a major problem in
Western countries (Engelke, 2013; Ribes
et al., 2009). It is a neoplasm that develops
in the rectum, sigmoid, descending colon,
transverse colon, and ascending colon (Cuffy, Abir,
Audisio, & Longo, 2004). Unfortunately, 8%– 29% of
colorectal cancer patients may present as an emergency
case; this includes, but is not limited to, perforation,
hemorrhage, and obstruction. The presentation of a
patient with these conditions can lead to worse out-
comes (Barnett et al., 2013; Cuffy et al., 2004).
Sagar (2011) described that emergency surgical
decompression is the traditional treatment of choice
for obstruction, but it is associated with high morbid-
ity and mortality. Therefore, in recent years, colonic
stents have been used to relieve the obstruction. The
advantages of colorectal stents include a shorter hospi-
tal stay and procedure time as well as less blood loss
(Gainant, 2012).
Background
Colonic stenting or self-expanding metallic stents
(SEMSs) have been widely used all over the world.
Colorectal stent placement can be done under fluoros-
copy and endoscopic guidance (De-Gregorio et al.,
2004; Lopera & De Gregorio, 2010). Because this is a
Management of Colorectal Cancer Patients
Undergoing a Colonic Stenting
A Multidisciplinary Team Approach
ABSTRACT
Colonic stent procedure is one of the best therapeutic medical interventions for managing a colorectal cancer patient
with large bowel obstruction. This is a retrospective study that evaluated data from the past 10 years; it examined the
epidemiological and clinical data of patients with colorectal cancer undergoing a colonic stent procedure. In addi-
tion, this study prospectively evaluated the nurse’s roles during a colonic stent procedure, and at the same time, it
explored the patient’s satisfaction with the procedure at the Hospital Universitario Central de Asturias (Spain). The
results revealed that for the last 10 years, a total of 102 patients underwent a colonic stent procedure. Male patients
outnumbered female patients by 2:1. The palliative group consisted of patients with multiple cancer metastases,
elderly patients, and patients with other comorbidities, whereas the preoperative group comprised those patients with
fewer comorbidities and no multiple cancer metastases. Survival time in the palliative group was 3 months without
any aggressive treatment, whereas patients with a favorable condition and fit for surgery after a colonic stent proce-
dure had a survival time of 28 months. In the prospective study, nurses implemented care in terms of a multidiscipli-
nary team approach of safety culture that included patient safety, equipment safety, and environment and procedure
safety. Therefore, the level of patient satisfaction was high. In conclusion, management of a colorectal cancer patient
undergoing colonic stenting performed at the Hospital Universitario Central de Asturias has high technical and clinical
success, and it is a quality procedure that includes a multidisciplinary team approach.
Bejo Utomo, MSc, RN
Carmen Alvarez, RN
Ricardo F. Baldonedo, MD, PhD
Received October 1, 2014; accepted January 19, 2016.
About the authors: Bejo Utomo, MSc, RN, is Erasmus Mundus Master
in Emergency and Critical Care Nursing, University of Oviedo, Asturias,
Spain.
Carmen Alvarez, RN, is Endoscopist Supervisor Nurse, Hospìtal
Universitario Central de Asturias, Asturias, Spain.
Ricardo F. Baldonedo, MD, PhD, is Lecturer in Medical and Surgical
Nursing, Faculty of Medicine and Health Sciences, University of Oviedo,
Asturias, Spain.
The authors declare no conflicts of interest.
Correspondence to: Bejo Utomo, MSc, RN, University of Oviedo,
Asturias, Spain (gentole83@gmail.com).
DOI: 10.1097/SGA.0000000000000255
Copyright © 2017 Society of Gastroenterology Nurses and Associates. Unauthorized reproduction of this article is prohibited.