title: Metal stents for malignant colorectal obstruction.
abstract: Malignant obstruction of the colon occurs in 7-25% of patients with colorectal cancer. As emergency laparotomy is reported to have relatively high morbidity and mortality rate, there is a need for alternative procedures with reduced complication rates. Over the last decade colorectal stenting has been reported as an alternative endoscopic method to relieve acute colonic obstruction. With the availability of more sophisticated stents and stent delivery systems, this approach has been used as a palliative method and as a pre-operative bridge to facilitate one-stage surgical resection of primary colonic tumors. Technical and clinical successes have been reported in 80-100% of treated patients. Distal lesions are more common and theoretically easier to stent although lesions within the ascending colon have been successfully managed. Minor complications include transient anorectal pain, tenesmus and rectal bleeding. However, stent migration and colonic perforation are also well recognized. Despite the fact that no randomized controlled studies have yet been performed, literature data show that colonic stenting is a safe and effective procedure and can reduce costs, avoiding the need for colostomy and improving the quality of life of patients with advanced disease.
authors.affiliation: Department of Gastroenterology, Digestive Endoscopy Unit, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, I-20089 Rozzano, Milan, Italy. alessandro.repici@humanitas.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Repici
authors.forename: Nico
authors.initials: N
authors.lastname: Pagano
authors.forename: Cristina Marfinati
authors.initials: CM
authors.lastname: Hervoso
authors.forename: Silvio
authors.initials: S
authors.lastname: Danese
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Nicita
authors.forename: Paoletta
authors.initials: P
authors.lastname: Preatoni
authors.forename: Alberto
authors.initials: A
authors.lastname: Malesci
mesh_terms: D003108:Colonic Diseases / Q000209:etiology* / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000150:complications* / Q000628:therapy*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000628:therapy*; D008670:Metals; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D008670:Metals