[Role of self-expanding stent in the treatment of obstructing colorectal cancer]. / L'endoprothèse dans l'occlusion colique tumorale.

BACKGROUND: Obstruction due to colorectal cancer is a common occurrence. It often arises in patients in poor general condition with malnutrition and advanced tumor stage. Prognosis can be improved by prompt resolution of obstruction through a mininimally invasive approach. GOAL: To analyze the management of cases of acute colorectal obstruction and evaluate the efficacity and morbidity/mortality associated with the use of endocolic stent prostheses. MATERIAL AND METHODS: This retrospective study at a single center evaluated patients presenting with acute colorectal obstruction between January 2003 and May 2008, assessing the patient sample, cancer characteristics, treatment, and morbidity/mortality. RESULTS: The mean age of the 26 patients was 75 years; ASA Class was greater than III in 63% of cases, The colorectal cancer was located in the sigmoid in 65% of cases and was a Stage IV tumor in 73% of cases. Placement of an endocolic stent was the primary intervention in 94% of patients. Morbidity was 12% and mortality was 4%. CONCLUSION: Colonic stenting is an effective therapeutic option in the elderly with painful symptoms of obstruction and should be the initial approach.

Osteoid osteoma distal to a hip arthroplasty.

The authors report a case of osteoid osteoma distal to a hip prosthesis in a 56-year-old patient. This rare association was difficult to diagnose; at first, the pain seemed to be of mechanical origin, suggesting a delayed painful reaction to the prosthesis. The results of bone scan as well as the CT scan ones helped orient the diagnosis. Excision biopsy, using bone trephining, completed by an iliac bone auto-graft resulted in a cure with no residual instability of the prosthesis above the tumor. Bone scan with radio-isotopes to localize the lesion was particularly helpful in this instance to secure the final diagnosis.