Metal stents for malignant colorectal obstruction.
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.
Repici
Alessandro
A
Department of Gastroenterology, Digestive Endoscopy Unit, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, I-20089 Rozzano, Milan, Italy. alessandro.repici@humanitas.it
Pagano
Nico
N
Hervoso
Cristina Marfinati
CM
Danese
Silvio
S
Nicita
Rinaldo
R
Preatoni
Paoletta
P
Malesci
Alberto
A
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
D008670:Metals