COLONIC STENTS IN COLORECTAL OBSTRUCTION

Obstruction is the presenting symptom of colorectal cancer in up to 40 per cent of patients. Benign strictures and other neoplasms including lymphoma and gynecologic tumors occur as well. Emergent operative the rapy is often suboptimal and associated with significant morbidity and mortality, Our objective was to review our experience with stent plac ement for colonic obstruction. Seven patients underwent stent placemen t for a total of eight procedures. There were three patients with unre sectable colorectal cancer, two patients with metastatic gynecologic c ancer, one patient with rectal lymphoma, and one patient with metastat ic cancer of unknown primary. All colonic stents were Wallstents place d by the same endoscopist under fluoroscopic and endoscopic guidance. Stents were successfully placed in all patients without complication. One patient underwent placement of two stents in succession for a long stenosis. Six of seven patients (86%) had resolution of the obstructi on and return of bowel function. Five of seven were tolerating a diet within 24 hours. One patient's mental status did not allow for oral in take. Four patients were discharged within 48 hours. Two patients died within the same hospitalization as a result of metastatic disease. On e patient was found to have multilevel disease requiring stoma placeme nt. There was Ho morbidity or mortality associated with stent placemen t, and 86 per cent of patients had palliation of the obstruction. We c onclude that colonic stent placement is a safe and effective therapy f or colorectal obstruction at this institution.