[Self-expandable metal stent in the treatment of obstructive cancer of the left colon. Preliminary results and review of the literature].
OBJECTIVE
To report our preliminary experience with self-expandable metal stent in the treatment of acute malignant obstruction of the left colon and to review the literature on this specific subject.


METHODS
From March to September 1999, 8 consecutive patients with a mean age 71 were admitted as an emergency for acute malignant obstruction of the left colon. A self-expandable metal stent was inserted under radioscopic and, in 4 cases, endoscopic guidance. The patients then underwent bowel preparation before operation, if required.


RESULTS
There was no mortality. Bowel preparation was satisfactory in 6 cases. Complications occurred in 1 patient, who was operated on day one for peritonitis due to perforation of the tumour by the prosthesis inserted after dilatation. Another six patients were operated: 2 had resection followed by anastomosis; 3 had resection and anastomosis protected by ileostomy; 2 had Hartmann's procedure. The last patient retained the prosthesis as palliation. In the literature, self-expandable metal stent application in obstructed carcinoma of the left colon gives satisfactory results.


CONCLUSIONS
Based on our experience and a review of the literature, we provide practical recommendations when inserting self-expandable metal stents for acute malignant left colonic obstruction.
Desroches
E
E
Service de Chirurgie Générale et Digestive, Hôpital Michallon, Grenoble.
Faucheron
J L
JL
Sengel
C
C
Lachachi
F
F
Risse
O
O
Delannoy
P
P
Arvieux
C
C
Rolachon
A
A
Létoublon
C
C
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D003108:Colonic Diseases / Q000209:etiology / Q000601:surgery*; D003110:Colonic Neoplasms / Q000150:complications / Q000601:surgery*; D004322:Drainage; D004724:Endoscopy; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015607:Stents