The management of neoplastic colorectal obstruction with colonic endolumenal stenting devices

Background: Colonic endolumenal stenting (CELS) to treat obstructing colore ctal neoplasms was first described in 1991. The aim of this study was to re view the published world literature and make recommendations for its use in cur-rent clinical practice. Methods: Suitable English language reports were identified using a Medline search. Results: CELS can been successfully accomplished in 64% to 100% of obstruct ing malignant colonic lesions. Distal lesions are more common and theoretic ally more easy to stent although lesions within the ascending colon have be en successfully managed. Minor complications include transient anorectal pa in and rectal bleeding, however, significant complications of stent disloca tion and colonic perforation are also well recognized. Conclusion: CELS can aid the palliative management of malignant colorectal obstruction. Its role in relieving obstruction prior to resection remains t o be defined. Increasing experience has allowed the safe placement of stent s and relief of obstruction of virtually any lesion throughout the large bo wel. (C) 2001 Excerpta Medica, Inc. All rights reserved.