Acute colorectal obstruction: Treatment with self-expandable metallic stents before scheduled surgery - Results of a multicenter study

PURPOSE: To evaluate the efficacy of treatment with self-expandable metalli c stents for acute colonic obstruction before elective surgical resection. MATERIALS AND METHODS: In 71 patients with malignant obstruction seen from October 1993 through December 1996, lesions were located in the transverse colon in one patient, in the descending colon in 22 patients, and in the re ctosigmoid region in 48. A total of 72 self-expandable metallic stents were implanted within 23 hours of diagnosis. RESULTS: Technical success was obtained in 64 patients (90%). In two cases (3%), it was not possible to advance across the obstructing mass. In five c ases (7%), the prostheses were poorly positioned at the site of obstruction , requiring placement of a new stent in three cases. Clinical improvement a nd resolution of the obstruction were confirmed in 66 patients (93%) within 96 hours. Minor complications developed in nine cases (13%). One patient ( 1%) underwent surgery to resolve a colonic perforation caused by wires at t he ends of the stent. The mean time between stent placement and surgery was 8.6 days (range, 6-16 days). CONCLUSION: Implantation of colorectal stents is a safe treatment of acute malignant colonic obstruction before resection.