Advances in gastrointestinal intervention: The treatment of gastroduodenaland colorectal obstructions with metallic stents

Metallic stents are currently an established component of the endoluminal t reatment of stenoses within the blood vessels, bile ducts, esophagus,trache a, and bronchi. With the development of newer stent designs and delivery sy stems and the general momentum toward minimally invasive therapies, metalli c stent placement has expanded into the nonsurgical therapy for gastroduode nal and colorectal obstructions. The use of metallic stents within the stom ach, duodenum, or colon is intended not to be curative but to provide nonsu rgical palliation for the symptoms of gastric or colonic obstruction. This palliation may be intended for the life of the patient in the case of unres ectable disease or as a temporizing procedure prior to-a definitive surgica l procedure. In the latter clinical scenario, the benefits of a minimally i nvasive intestinal decompression procedure include (a) quick and noninvasiv e relief of the intestinal obstruction in an acutely ill patient that obvia tes a more extensive procedure; (b) allowance of time to improve a patient' s overall medical condition and thus to allow a patient to better tolerate the definitive surgical procedure; and (c) reduction of the complexity of t he definitive procedure by eliminating the need for staged procedures and a llowing the definitive procedure to be performed at one setting.