COLORECTAL OBSTRUCTION - TREATMENT WITH METALLIC STENTS

PURPOSE: To evaluate the usefulness of self-expandable metallic stents in the treatment of acute colonic obstruction secondary to colorectal neoplasm. MATERIALS AND METHODS: Stents were placed in 12 patients wi th clinical and radiologic signs of acute colonic obstruction. After s ymptom improvement, patients underwent radiologic staging. Single-stag e surgery was performed in patients without disseminated disease. RESU LTS: Stent placement was successful in all patients. Signs and symptom s of intestinal obstruction resolved within 24 hours of stent placemen t in 10 patients (83%). In two patients with massive bowel dilation, i mprovement was evident 2 and 4 days after stent placement. Ten patient s underwent elective single-stage surgery with partial colonic resecti on and creation of a primary end-to-end anastomosis without major comp lications. In two patients with disseminated neoplastic disease, stent placement was considered the primary palliative treatment. CONCLUSION : Metallic stent placement to relieve acute colonic obstruction second ary to colorectal carcinoma is a safe therapeutic alternative, allowin g single-stage surgery in suitable cases. In patients who are not surg ical candidates it is an adequate palliative option.