Self-expandable metallic stent placement as palliative treatment of obstructed colorectal carcinoma

Abstract

Stent placement can be considered safe and effective palliation for unresectable colorectal cancer. With technical modification of an esophageal stent, this procedure is now feasible. Stent placement in palliation of unresectable colon cancer is an alternative to surgical treatment. The through-the-scope stent for the exclusive treatment of colorectal cancer is not available in Japan. This report describes the use of an esophageal stent and the technical modifications required for its success in the treatment of colorectal strictures. We describe various technical strategies for colorectal stent placement and report on the outcomes.

Comparison of colonic stenting and open surgery for malignant large bowel obstruction

“…Of these, 12 were excluded because they represented either case series or case reports without comparative data [21][22][23][24][25][26][27][28][29][30][31][32]. An additional 2 studies were excluded because information on malignant large bowel obstruction could not be extracted from other data [33,34].…”

Palliative stent implantation in the treatment of malignant colorectal obstruction

“…However, most references are related to carcinomas of the left hemicolon and small groups of patients [3,12,15,17,18,[20][21][22]. In addition, most patients in the reports underwent SEMS implantation before a definitive surgical treatment (''bridge to surgery'' concept) for acute colorectal obstruction [23][24][25], or there were mixed groups of patients [18,26,27], leading to only limited conclusions on the long-term effect of SEMS implantation as definitive palliative treatment for obstructing colorectal carcinoma.…”

“…Numerous publications in recent years have confirmed the efficacy of stent implantation for the treatment of malignant colorectal obstruction, showing high technical and clinical success rates of 75% to 100% and 84% to 100%, respectively [10]. However, SEMS used exclusively with a palliative intention are less frequently reported, and most of the reported studies involved only small groups of patients [12,15,19].…”

A Comparison of Palliative Stenting or Emergent Surgery for Obstructing Incurable Colon Cancer

“…Most comparative studies suggest that endoscopically placed colonic SEMS are a viable alternative to surgery for palliative relief of colorectal obstruction for patients not suitable for tumor resection and to avoid a colostomy [5,12,[15][16][17]. Colorectal SEMS placement is technically successful in 78-100% and clinically successful in 84-100% of patients [5,7,12,15,[18][19][20].…”