title: Enteral stents for the management of malignant colorectal obstruction.
abstract: Colorectal cancer (CRC) is the 3rd most common cancer in the United States with more than 10000 new cases diagnosed annually. Approximately 20% of patients with CRC will have distant metastasis at time of diagnosis, making them poor candidates for primary surgical resection. Similarly, 8%-25% of patients with CRC will present with bowel obstruction and will require palliative therapy. Emergent surgical decompression has a high mortality and morbidity, and often leads to a colostomy which impairs the patient's quality of life. In the last decade, there has been an increasing use of colonic stents for palliative therapy to relieve malignant colonic obstruction. Colonic stents have been shown to be effective and safe to treat obstruction from CRC, and are now the therapy of choice in this scenario. In the setting of an acute bowel obstruction in patients with potentially resectable colon cancer, stents may be used to delay surgery and thus allow for decompression, adequate bowel preparation, and optimization of the patient's condition for curative surgical intervention. An overall complication rate (major and minor) of up to 25% has been associated with the procedure. Long term failure of stents may result from stent migration and tumor ingrowth. In the majority of cases, repeat stenting or surgical intervention can successfully overcome these adverse effects.
authors.affiliation: Jeremy Kaplan, Anna Strongin, Ali A Siddiqui, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Kaplan
authors.affiliation: Jeremy Kaplan, Anna Strongin, Ali A Siddiqui, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States.
authors.forename: Anna
authors.initials: A
authors.lastname: Strongin
authors.affiliation: Jeremy Kaplan, Anna Strongin, Ali A Siddiqui, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Adler
authors.affiliation: Jeremy Kaplan, Anna Strongin, Ali A Siddiqui, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Siddiqui
mesh_terms: D003108:Colonic Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000150:complications* / Q000473:pathology; D003664:Decompression / Q000009:adverse effects / Q000295:instrumentation*; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D010166:Palliative Care; D018579:Patient Selection; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012002:Rectal Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
keywords: Colonic obstruction; Colorectal cancer; Intestinal obstruction/etiology; Intestinal obstruction/mortality; Intestinal obstruction/surgery; Self expanding metal stents; Survival rate