Transendoscopic balloon dilatation of complete colonic obstruction. An adjunct in the treatment of colorectal cancer: report of three cases.
Complete colonic obstruction secondary to colorectal cancer has traditionally been managed by a staged approach. Simple diversion or resection with colostomy is performed followed by reestablishment of intestinal continuity at a subsequent operation. The use of a transendoscopic technique of balloon dilatation for complete malignant obstruction in the management of three patients is discussed. Successful balloon dilatation allowed for complete bowel preparation and either elective single-stage resection or controlled Nd:YAG laser palliation in a clean field. Although not applicable to all clinical situations, balloon dilatation is a valuable adjunct in the management of obstructing colorectal cancer. Relief of obstruction by tumor dilatation allows 1) correction of fluid and electrolyte abnormalities, 2) administration of a complete bowel preparation, 3) single-stage resection and anastomosis, or 4) palliative laser photoablative therapy that avoids the need for colostomy.
Stone
J M
JM
Division of General Surgery, Veterans Administration, Palo Alto, California 94304.
Bloom
R J
RJ
D000368:Aged; D002404:Catheterization / Q000379:methods*; D003108:Colonic Diseases / Q000209:etiology / Q000628:therapy*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications* / Q000601:surgery; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care