Preoperative colonic stenting: how, when and why?
OBJECTIVE
Acute colonic obstruction due to malignancy is often a surgical emergency. Surgical decompression with colostomy with or without resection and eventual re-anastomosis has traditionally been the treatment of choice. These procedures have been associated with a significant morbidity and mortality rate. Preoperative colonic stenting is effective for decompressing the obstructed colon and may allow for surgery to be performed on an elective basis.


RESULTS
Although randomized clinical data are lacking, the role for preoperative stenting in the emergent management of acute malignant colonic obstruction has been supported by cost-effectiveness analysis studies and several pooled analyses that demonstrate efficacy and safety.


CONCLUSIONS
This review evaluates the latest developments in colonic stent technology, indications for use in the preoperative setting, and evidence to support their use in this setting.
Farrell
James J
JJ
Department of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA. jfarrell@mednet.ucla.edu
D000208:Acute Disease; D003110:Colonic Neoplasms / Q000150:complications; D003125:Colostomy / Q000295:instrumentation; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy; D015607:Stents