Endoscopic placement of self-expanding metal stents for treatment of colorectal obstruction with long term follow-up

Introduction: Relief of colorectal obstruction by means of self-expandable metal mesh stents (SEMS) has been suggested for palliation and acute decomp ression followed by optimization of the patients' general condition prior t o definitive surgery. Methodology: Twelve patients with high operative risk and/or metastatic dis ease were selected for stenting with a dedicated colorectal partly covered SEMS (Choo Colo-Rectal Stent, Solco Intermed Co., Seoul, Korea). Results: Stent deployment was successful in nine, two of whom had total obs truction. In one a guidewire perforation was treated conservatively. In two patients (one benign stricture, and one rectal cancer) the stents migrated within three weeks. One re-obstructed. In the remaining six patients colon ic decompression was achieved, and the stents have been patent until death after median 116 days (33-292 days). Conclusion: These results are promising, but data from several centres shou ld be compiled prospectively in a standardized fashion in order to allow fo r assessment of the method's safety and success rates before randomised tri als can be initiated.