Th. Baron et al., EXPANDABLE METAL STENTS FOR THE TREATMENT OF COLONIC OBSTRUCTION - TECHNIQUES AND OUTCOMES, Gastrointestinal endoscopy, 47(3), 1998, pp. 277-286
Background: Acute left-sided colonic obstruction is a surgical emergen
cy whose management is controversial. Because experience using expanda
ble metal stents for relief of this type of obstruction is limited, we
evaluated their effectiveness, feasibility, safety, and outcome. Meth
ods: Twenty-five patients with acute colorectal obstruction underwent
placement of various metal stents under fluoroscopic and endoscopic gu
idance. On an intent-to-treat basis, stents were placed for decompress
ion before one-stage surgical resection in 10 patients and palliativel
y in 15 patients. Two preoperative patients had unresectable malignant
disease, and stents were left for palliation resulting in 17 palliati
ve and 10 preoperative patients for analysis. Results: Stent placement
was technically successful in 94% of patients. Overall effectiveness
in relieving obstruction was 85% (palliative 82%, preoperative 90%). I
n the palliative group, stent duration ranged from 2 to 64 weeks (mean
17.3 weeks). Major complications occurred in 7 patients (30%). Conclu
sions: Expandable metal stents are a feasible, effective adjunct and a
lternative to surgery for acute colorectal obstruction.