Gastrointestinal Tract Stenting

Large Bowel Obstruction

“…Stenting is associated with stent migration and ingrowth or incorporation of the stent into the bowel wall. 5 The FDA has approved the use of self-expandable metal stents (SEMS) for malignant colon obstructions but not for benign obstructions. 5 Patients with obstructions secondary to inflammatory bowel disease may undergo balloon dilation without stenting for management.…”

“…5 The FDA has approved the use of self-expandable metal stents (SEMS) for malignant colon obstructions but not for benign obstructions. 5 Patients with obstructions secondary to inflammatory bowel disease may undergo balloon dilation without stenting for management. 6 Dilation has proven safety in this population but comes with risks and the likely need for repeated procedures.…”

“…However, there is concern for migration, need for multiple procedures, ingrowth or incorporation of the stent into the bowel wall. 5 These complications have likely been evaluated and documented more in the benign setting because these patients are followed for longer periods of time compared with the cancer population. Whether stenting is used for benign or malignant disease, there may be benefit in using SEMS as a bridge to surgery and as a palliative treatment option.…”

“…Whether stenting is used for benign or malignant disease, there may be benefit in using SEMS as a bridge to surgery and as a palliative treatment option. 3,5 Another strategy that has been developing over the past decade is endoscopic laser coagulopathy. This has been used to bypass high-grade strictures to allow for dilation and/or SEMS placement.…”

“…7 There is also some growing evidence for fluoroscopic and percutaneous stent placement in the medical literature. 5 As endoscopic and other therapeutic strategies develop, we may see a greater role for endoscopy in the management of LBOs.…”