Colorectal Stenting for Management of Acute Malignant Bowel Obstruction in Advanced Colorectal Cancer in Iran

Abstract

<br/><b>Introduction</b>: Enteral stenting is used increasingly as a palliative treatment of gastrointestinal malignant ornon malignant obstructions. This aim of this study was to evaluate the role of endoscopic stent implantation forpalliation of acute colorectal cancer obstruction in critical patients. <br/><b>Methods</b>: This study was performedprospectively with 8 patients suffering clinical manifestations of acute bowel obstruction with severe co-morbiddiseases that caused them to be inoperable. They were treated by semi-elective stent insertion after primaryresuscitation. Gentle dilation of stricture with balloon or buginage was performed under fluoroscopy andcolonoscopy in gastrointestinal ward without complete preparation. Then an uncovered self-expanding metalstent was inserted over guide wire in the location of the tumor. <br/><b>Results</b>: Endoscopic stent implantation could besuccessfully performed in six patients. In early days after stent insertion; general condition of patients graduallyimproved, and symptoms of acute obstruction was relieved. In two of the cases stent was inserted with difficultydue to very tortuous and complex strictures. Complications of stenting in this study were very rare. Displacementof stent after successful insertion was not seen . Of our studied patients, two died after 2 months, one after 4months and three of them after 7-8 months. The cause of death in these patients was advanced metastatic lesionin liver, lung, bone and severe underlying disease such as heart failure. <br/><b>Conclusion</b>: Endoscopic stent implantationseems to be an effective and safe palliative approach for management of emergency conditions of acute colonicobstruction in inoperable patients with advanced colorectal cancer.