APPLICATION OF RECTAL STENTS FOR PALLIATION OF OBSTRUCTING RECTOSIGMOID CANCER

Background: The rationale of palliative endoscopic treatment is to avo id a colostomy in patients with advanced disease and Limited life expe ctancy. This study was conducted to evaluate the role of endoscopic st ent implantation for palliation of obstructing rectal cancer. Methods: Overall, 19 patients (aged 47-87 years) with nonresectable or metasta tic rectal cancer were treated by stent insertion after laser recanali zation or dilation. Three types of stents, i.e., plastic tubes (n = 8) , self-expanding mesh stents (n = 6), and endocoil stents (n = 5), wer e used to maintain luminal patency. Results: Endoscopic stent implanta tion was successfully performed in all 19 patients. Long-term luminal patency and satisfactory bowel function were achieved in 16 of 19 pati ents (84%). After a median follow-up of 6 months, eight of the patient s have died and eight are still alive without evidence of recurrent, o bstruction. Dislocation of the endoprosthesis occurred in two of eight plastic tubes and one of five mesh stents. Recurrent obstruction due to turner in grow th was only observed in patients treated with self-e xpanding mesh stents (n = 2). in spite of reinsertion and laser therap y a colostomy was required in three of 19 patients. There was no evide nce of treatment failure in five patients who received endocoil stents . None of the patients experienced serious complications related to th e endoscopic procedure. Conclusions: Endoscopic stent implantation see ms to be a safe and efficient palliative approach to selected patients with obstructing rectal cancer. Currently, self-expanding coil stents are superior to other devices because of lower risk of dislocation an d tumor ingrowth.