title: Safety and efficacy of metallic stents in the management of colorectal obstruction.
abstract: BACKGROUND
  The use of self-expandable metallic stents in the management of obstructing colorectal cancer has been described with increasing frequency in the literature. Our goal was to evaluate the efficacy and associated morbidity of the use of self-expandable metallic stents to relieve colorectal obstruction at our institution.
  
  
  METHODS
  A retrospective chart review of patients who underwent colorectal stent placement between December 2001 and December 2003 in a tertiary referral center was performed.
  
  
  RESULTS
  Stents were placed successfully in 17 of 21 patients (81%) with colorectal obstruction. Placement was achieved endoscopically in 13 patients and radiologically in 4. Ten self-expandable metallic stents were used as a bridge to surgery, and 7 were used for palliation. The obstructions were located in the sigmoid colon (11 patients), the rectosigmoid (3), the splenic flexure, the hepatic flexure, and the rectum. Malignant obstruction was noted in 14 patients. One patient with malignancy experienced a sigmoid perforation, and 2 patients with benign disease had complications (1 stent migration and 1 re-obstruction). Stent patency in obstruction secondary to colonic adenocarcinoma was 100% in our follow-up period (range, 5 to 15 months).
  
  
  CONCLUSIONS
  The use of stents as a bridge to surgery is associated with low morbidity, allows for bowel preparation, and thus avoids the need for a temporary colostomy. Long-term patency suggests that stents may allow for the avoidance of an operation in patients with metastatic disease and further defines their role in the palliation of malignant obstruction. Further prospective randomized studies are necessary to fully elucidate the use of stents in the management of colorectal cancer.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, University of Texas Health Science Center, San Antonio 78229-3900, USA.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Stefanidis
authors.forename: Ken
authors.initials: K
authors.lastname: Brown
authors.forename: Hector
authors.initials: H
authors.lastname: Nazario
authors.forename: Hector H
authors.initials: HH
authors.lastname: Trevino
authors.forename: Hector
authors.initials: H
authors.lastname: Ferral
authors.forename: Charles E
authors.initials: CE
authors.lastname: Brady
authors.forename: Glenn W
authors.initials: GW
authors.lastname: Gross
authors.forename: Darren W
authors.initials: DW
authors.lastname: Postoak
authors.forename: Riaz
authors.initials: R
authors.lastname: Chadhury
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Rousseau
authors.forename: Morton S
authors.initials: MS
authors.lastname: Kahlenberg
mesh_terms: D000230:Adenocarcinoma / Q000150:complications*; D000368:Aged; D003110:Colonic Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D008670:Metals; D008875:Middle Aged; D010166:Palliative Care; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents
chemical_list: D008670:Metals