title: Managing acute colorectal obstruction by "bridge stenting" to laparoscopic surgery: Our experience.
abstract: OBJECTIVE
  To verify the clinical results of the endoscopic stenting procedure for colorectal obstructions followed by laparoscopic colorectal resection with "one stage anastomosis".
  
  
  METHODS
  From March 2003 to March 2009 in our surgical department, 48 patients underwent endoscopic stenting for colorectal occlusive lesion: 30 males (62.5%) and 18 females (37.5%) with an age range from 40 years to 92 years (median age 69.5). All patients enrolled in our study were diagnosed with an intestinal obstruction originating from the colorectal tract without bowel perforation signs. Obstruction was primitive colorectal cancer in 45 cases (93.7%) and benign anastomotic stricture in 3 cases (6.3%).
  
  
  RESULTS
  Surgical resection was totally laparoscopic in 69% of cases (24 patients) while 17% (6 patients) of cases were video-assisted due to the local extension of cancer with infiltrations of surrounding structures (urinary bladder in 2 cases, ileus and iliac vessels in the others). In 14% of cases (5 patients), resection was performed by open surgery due to the high American Society of Anesthesiologists score and the elderly age of patients (median age of 89 years). We performed a terminal stomy in only 7 patients out of 35, 6 colostomies and one ileostomy (in a total colectomy). In the other 28 cases (80%), we performed bowel anastomosis at the same time as resection, employing a temporary ileostomy only in 5 cases.
  
  
  CONCLUSIONS
  Colorectal stenting transforms an emergency operation in to an elective operation performable in a totally laparoscopic manner, limiting the confection of colostomy with its correlated complications.
authors.affiliation: Pierfrancesco Bonfante, Luigi D'Ambra, Stefano Berti, Emilio Falco, Department of Surgery, S.Andrea Hospital of La Spezia, 19100 La Spezia, Italy.
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Bonfante
authors.forename: Luigi
authors.initials: L
authors.lastname: D'Ambra
authors.forename: Stefano
authors.initials: S
authors.lastname: Berti
authors.forename: Emilio
authors.initials: E
authors.lastname: Falco
authors.forename: Massimo Vittorio
authors.initials: MV
authors.lastname: Cristoni
authors.forename: Romolo
authors.initials: R
authors.lastname: Briglia
keywords: Colonic stenting; Colorectal cancer; Endoscopy; Intestinal obstruction; Laparoscopy