Endoscopic treatment of colonic obstruction.
OBJECTIVE
Over the past 15 years, great strides have been made in the nonsurgical management of malignant large bowel obstruction. Progress continues, particularly in the area of self-expanding metal stents. The purpose of this review is to assess the available endoscopic techniques for colonic decompression and document the inexorable trend toward supremacy of the self-expanding metal stent in this arena.


RESULTS
Stents are being designed with the structure and function of the colon in mind allowing better and longer-lasting palliation. Improvement in the design of the colonic decompression tube allows a low-tech approach to the palliation of colonic obstruction. Argon plasma coagulation is helpful in restoring continuity of the obstructed colonic lumen in certain circumstances.


CONCLUSIONS
As a consequence of technological innovation and growing expertise in the community, gastroenterology is becoming the go to specialty in the early management and palliation of malignant bowel obstruction.
Dekovich
Alexander A
AA
Department of Gastroenterology, Hepatology and Nutrition, University of Texas - M.D. Anderson Cancer Center, Houston, Texas 77030, USA. adekovich@mdanderson.org
D003110:Colonic Neoplasms / Q000150:complications / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D019299:Decompression, Surgical / Q000379:methods; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D017075:Laser Coagulation; D015607:Stents; D016896:Treatment Outcome