Colorectal obstruction: Treatment with metallic stents

PURPOSE: To evaluate the usefulness of self-expandable metallic stents in the treatment of acute colonic obstruction secondary to colorectal neoplasm. MATERIALS AND METHODS: Stents were placed in 12 patients with clinical and radiologic signs of acute colonic obstruction. After symptom improvement, patients underwent radiologic staging. Single-stage surgery was performed in patients without disseminated disease. RESULTS: Stent placement was successful in all patients. Signs and symptoms of intestinal obstruction resolved within 24 hours of stent placement in 10 patients (83%). In two patients with massive bowel dilation, improvement was evident 2 and 4 days after stent placement. Ten patients underwent elective single-stage surgery with partial colonic resection and creation of a primary end-to-end anastomosis without major complications. In two patients with disseminated neoplastic disease, stent placement was considered the primary palliative treatment. CONCLUSION: Metallic stent placement to relieve acute colonic obstruction secondary to colorectal carcinoma is a safe therapeutic alternative, allowing single-stage surgery in suitable cases. In patients who are not surgical candidates it is an adequate palliative option.