Role of endoscopic colonic stent insertion in patients with colonic obstructing malignancy: a single-center study

Abstract

Background Left-sided colonic malignant lesions have the potential of acute bowel obstruction. Emergency surgery with stoma construction is considered the standard of management. Insertion of colonic stent to allow bowel decompression, primary resection, and re-anastomosis, avoiding the need of colostomy formation, can be an alternative. We describe our experience with the use of colonic stent in left-sided malignant obstruction as a step to relieve the obstruction before definitive surgical intervention. Patients and methods A total of 30 patients with left-sided colonic malignant obstruction were included; 15 patients were offered colonic self-expandable metal stent insertion, and the other fifteen patients were offered emergent surgery. Results Of the 15 patients, 10 (66.6%) had successful stent insertion (technical and clinical). We failed to insert stent in four (26%) patients, and one (6.6%) patient had colonic perforation. All patients with successful colonic stent insertion underwent one-step resection and primary anastomosis. Conclusion Colonic stent for left-sided colonic malignant obstruction represents a valuable procedure for one-step resection and primary anastomosis without the need for colostomy.

Keywords

• colostomy
• obstruction
• stent