Endoluminal stenting for relief of colonic obstruction is safe and effective

Abstract

Endoluminal stenting is safe and effective, and cost effective for palliation. We advocate a multicentre randomized prospective trial of best practice emergency surgery vs endoluminal stenting and subsequent elective surgery for large bowel obstruction.

Stents or Open Operation for Palliation of Colorectal Cancer: A Retrospective, Cohort Study of Perioperative Outcome and Long-term Survival

“…One patient died three days after stent insertion from liver failure and widespread metastatic disease. The mean length of stay was four (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] days. This includes one patient with a 17-day stay because of an ongoing, malignant, small-bowel obstruction and another patient with a 19-day stay, which was necessary while waiting for a bed at another institution for convalescence.…”

“…Subsequently, there have been many reports of their use as a palliative measure for patients with metastatic disease. [11][12][13][14] A recent review has shown that colorectal stents can be successfully inserted as a palliative procedure with low morbidity and mortality. 15 All publications to date have been case series, single case reports, and reviews.…”

Clinical Application of Self-Expandable Metallic Stent for Treatment of Colorectal Obstruction Caused by Extrinsic Invasive Tumors

“…It allowed time for resuscitation, rehydration, and hyperalimentation before surgery and also enabled the patient to avoid stoma formation, which is associated with psychologic stress for its management and financial problems. 6,11 In addition, this procedure may shorten the length of hospital stay and be more cost-effective than surgeries. 6,[16][17][18] In contrast to colorectal cancers, in which the obstructions develop from intraluminal growth, obstructions by metastatic or invasive noncolorectal cancer develop from extrinsic compression.…”

“…6,11 In addition, this procedure may shorten the length of hospital stay and be more cost-effective than surgeries. 6,[16][17][18] In contrast to colorectal cancers, in which the obstructions develop from intraluminal growth, obstructions by metastatic or invasive noncolorectal cancer develop from extrinsic compression. Because obstruction and tumor characteristics differ between colorectal cancer and extrinsic tumor-related obstruction, the results of SEMS insertion are expected to be different.…”

“…[2][3][4][5] Furthermore, emergency surgery, usually a diverting colostomy, reduces the quality of life and increases the psychologic stress of introducing a stoma. 6 Since the first successful stent placement with malignant colorectal obstruction in 1991, 7 many reports have been presented on the usefulness of stent insertion for treatment of colorectal obstructions caused by colorectal cancer. Stent deployment in colorectal cancer has been effective in both preoperative decompression of acute colorectal obstruction, the so-called bridge to surgery, to allow time to perform elective surgery and for palliation in patients who are not candidates for surgery.…”