Endoscopic stent placement in the management of malignant colonic obstruction: Experiences from two centers.
OBJECTIVE
Intestinal obstruction due to colorectal tumors requires immediate surgical decompression. Endoscopic stent placement for acute malignant colonic obstruction is gaining widespread acceptance as an alternative to emergency surgery. Our aim in this study was to evaluate the success and complication rates of endoscopic stenting for malignant colonic obstruction.


METHODS
Patients with acute malignant colonic obstruction who underwent endoscopic stenting between 2011-2014 were retrospectively reviewed. Data included demographic features, localization of obstruction, endoscopic stenting indications, rate of technical and clinical success, complications, morbidity and mortality.


RESULTS
Endoscopic stent was successfully placed in 77 out of 82 procedures (93.9%). A colostomy was placed in five cases in which endoscopic stent could not be inserted. There were complications in seven patients with technically successful stents (9.0%). These included three stent migrations, one perforation, and rectal hemorrhage in three patients. There were no stent-related deaths.


CONCLUSIONS
The mortality rate of emergency surgery for malignant bowel obstruction is relatively high. The use of colonic stents can avoid surgery in patients who are not suitable for emergency surgery and may allow adequate time for preoperative preparation, counseling and staging for those who are suitable for further intervention. We believe that self-expandable metallic stent placement is a safe, effective, and minimal invasive alternative treatment method for malignant colonic obstruction.
Clinic of General Surgery, İstanbul Training and Research Hospital, İstanbul, Turkey.
Bünyamin
B
Gürbulak
Clinic of General Surgery, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.
Esin Kabul
EK
Gürbulak
Clinic of General Surgery, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.
İsmail Ethem
İE
Akgün
Clinic of General Surgery, İstanbul Training and Research Hospital, İstanbul, Turkey.
Kenan
K
Büyükaşık
Clinic of General Surgery, İstanbul Training and Research Hospital, İstanbul, Turkey.
Hasan
H
Bektaş
Colorectal carcinoma; malignant intestinal obstruction; self-expandable colonic stent