Self-expandable metallic stents as palliative treatment for malignant colorectal obstruction

Abdom Imaging. 2007 Sep-Oct;32(5):619-23. doi: 10.1007/s00261-006-9159-z.

Abstract

Background: In recent years, stent placement for malignant colorectal obstruction has become an accepted alternative to surgery. The purpose of this study was to evaluate the usefulness of self-expandable metallic stents (SEMS) as palliative management for patients with unresectable malignant colorectal obstruction.

Methods: Twelve patients with unresectable malignant colorectal obstruction were treated with SEMS as palliative therapy. The sites of obstruction were located in the rectum (n = 9), the descending colon (n = 1), and the transverse colon (n = 2). All procedures were performed with combined endoscopic and fluoroscopic guidance. We analyzed the technical and clinical success rates of stent placement and the complications associated with the procedure.

Results: The stents were successfully implanted and bowel obstruction was relieved in all cases; the technical and clinical success rates were 100%. Two complications occurred, including stent migration. There was no case requiring reintervention. All patients died of initial disease or another coexisting disease between 9 and 534 days (mean 133 +/- 148 days) after stent placement. None of the patients with stent in position at death had clinical or radiologic signs of bowel obstruction.

Conclusions: SEMS placement in patients with malignant colorectal obstruction is technically feasible and safe, making it useful as a palliative treatment.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colon / pathology
  • Colorectal Neoplasms / therapy*
  • Female
  • Fluoroscopy / methods
  • Humans
  • Intestinal Obstruction / therapy*
  • Male
  • Middle Aged
  • Palliative Care
  • Rectum / pathology
  • Stents*
  • Treatment Outcome