title: Self-expandable metallic stent placement as palliative treatment of obstructed colorectal carcinoma.
abstract: BACKGROUND
  Stent placement in palliation of unresectable colon cancer is an alternative to surgical treatment. The through-the-scope stent for the exclusive treatment of colorectal cancer is not available in Japan. This report describes the use of an esophageal stent and the technical modifications required for its success in the treatment of colorectal strictures. We describe various technical strategies for colorectal stent placement and report on the outcomes.
  
  
  METHODS
  Medical records of patients who underwent palliative colonic stenting between June 1997 and March 2003 were reviewed retrospectively, and the clinical outcome was evaluated.
  
  
  RESULTS
  Insertion of a metallic esophageal stent was attempted in 12 patients (mean age, 73.0 years; 5 male, 7 female). Location of the stricture was in the rectum in 4 patients and in the sigmoid, descending, or transverse segments of the colon in 5, 1, and 2 patients, respectively. Two patients had recurrent colon cancer after surgery. The remaining 10 patients did not undergo surgery. Stent placement was technically successful in 11 patients, giving a technical success rate of 92%. Following successful stent placement, all but 1 patient obtained clinical success, generating a clinical success rate of 83%. Late complications occurred in 4 patients and included 2 migrations, 2 bleeds, and 1 obstruction. The complication rate of the procedure was 33.3%. There was no mortality or severe complications. The median survival period was 120 days.
  
  
  CONCLUSIONS
  Stent placement can be considered safe and effective palliation for unresectable colorectal cancer. With technical modification of an esophageal stent, this procedure is now feasible. Stent placement in palliation of unresectable colon cancer is an alternative to surgical treatment. The through-the-scope stent for the exclusive treatment of colorectal cancer is not available in Japan. This report describes the use of an esophageal stent and the technical modifications required for its success in the treatment of colorectal strictures. We describe various technical strategies for colorectal stent placement and report on the outcomes.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Hospital, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.
authors.forename: Iruru
authors.initials: I
authors.lastname: Maetani
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tada
authors.forename: Takeo
authors.initials: T
authors.lastname: Ukita
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Inoue
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Saida
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sakai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications / Q000628:therapy*; D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000150:complications / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome