METAL STENTS FOR PALLIATION OF RECTAL-CARCINOMA - A PRELIMINARY-REPORT ON 12 PATIENTS

Background and Study Aims: Laser therapy is often the only alternative to palliative surgery for elderly patients with advanced rectal carci noma, In order to reduce the number of laser sessions required, we tri ed to insert metal stents after initial relief of the obstruction. Pat ients and Methods: In 12 patients (seven female, five male, aged 77-91 years) with rectal or rectosigmoid carcinomas, metallic self-expandin g stents (length 5-10 cm, internal diameter 1-2 cm) were introduced, I nitial treatments were performed with Nd:YAG laser (mean number of ses sions 3.1) in order to allow free passage of an adult colonoscope. End oscopic and clinical follow-up was carried out at regular intervals. R esults: Stent insertion was possible in 11 of the 12 patients, Failure occurred in one patient with sigmoid carcinoma with a distorted loop and diverticulosis. In three patients, the prostheses migrated due to the opening of the lumen being too large; after stent removal, a secon d stent was successfully placed, Seven patients have died since the be ginning of the study, all from the initial disease, without symptoms o f stent occlusion. Stenting allowed the number of laser sessions to be reduced, The interval between the laser sessions was extended from 5. 1 weeks in a historical control group of 65 patients to the 9.7 weeks in these 11 patients with additional stenting. Conclusion: Stenting fo r rectal carcinoma is technically feasible and safe, and probably redu ces the number of laser sessions required. However, better materials a re required.