Self-expanding metal stent insertion by colorectal surgeons in the management of obstructing colorectal cancers: a 6-year experience
Placement of a self-expanding metal stent (SEMS) in patients presenting with colorectal cancer as an acute large bowel obstruction may obviate emergency surgery, potentially effectively palliating incurable cancers and acting as a bridge to surgery in patients with operable tumours. We present our experience with stenting for malignant acute large bowel obstruction over a 6-year period (2006–2011). A prospectively compiled colorectal cancer database was reviewed to identify all patients presenting to our unit with malignant acute large bowel obstruction who had stenting carried out to achieve colonic decompression. All 44 procedures were performed by colorectal surgeons using a combined endoscopic and fluoroscopic technique. Overall, successful decompression was achieved in 42 patients by SEMS insertion (95.5 %). Technical and clinical success was achieved in all 30 patients undergoing stenting as a palliative measure (100 %). There was no clinical perforation in any of the 44 patients. SEMSs insertion is a safe and effective technique for colonic decompression in the setting of acute malignant large bowel obstruction as either a palliative measure or as a bridge to subsequent resection.